NEUROPSYCHIATRIC ADVERSE-EFFECTS OF ANTIPARKINSONIAN DRUGS - CHARACTERISTICS, EVALUATION AND TREATMENT

Parkinson's disease (PD) is a progressive neurological condition that causes considerable disability in the elderly, Drugs used to treat PD, such as levodopa, offer symptomatic relief but often have neuropsychi atric adverse effects, most prominently psychosis and delirium, Aged p atients: and those with dementia are particularly vulnerable to these adverse effects. Evaluating PD patients with drug induced neuropsychia tric adverse effects is made difficult by their complex clinical prese ntations, The treatment of drug-induced psychosis and delirium begins with manipulating the antiparkinsonian drug regimen, but this frequent ly worsens motor function, Atypical antipsychotics such as clozapine h ave been successfully employed to treat the psychosis without worsenin g the motor disability. Patient intolerance of clozapine therapy has p rompted open-label studies with newer agents such as risperidone, remo xipride, zotepine, mianserin and ondansetron.