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Treating Hallucinations and Delusions Associated With Parkinson's Disease Psychosis
Shyam C Panchal1, William G Ondo2
1Department of Neurology, Houston Methodist Neurological Institute, 6560 Fannin Street; Scurlock Tower, Suite 802, Houston, TX, 77030, USA. spanchal@houstonmethodist.org.
Purpose Of Review:
We discuss features of Parkinson's disease psychosis (PDP) including symptomology and pathophysiology. Treatment options, including non-pharmacologic strategies, dose reduction of offending agents, and the addition of non-dopaminergic antipsychotics, are addressed. The efficacy of second-generation antipsychotics and novel agents is examined.
Recent Findings:
Pimavanserin, a 5-HT2A/C receptor inverse agonist with no other receptor activity, has shown efficacy and tolerability and is now FDA approved for PDP treatment. Research into novel targets is ongoing. PDP is a morbid complication of Parkinson's disease with complex incompletely understood mechanisms. Treatment is directed towards mitigation of psychosis without worsening of motor features.