Neuropsychiatric disorders in Parkinson's disease

Neuropsychiatric symptoms, such as depression, anxiety, cognitive changes, apathy or hallucinations are common in patients with Parkinson's disease (PD). They can appear at any stage of the disease and some symptoms may even be a harbinger of PD. These neuropsychiatric complications often become more pronounced as PD progresses and may worsen particularly during 'off-periods'. Moreover, neuropsychiatric symptoms are also frequently seen in patients with addictive behaviours, collectively called impulse control disorders, where insight is particularly low. In this narrative review, non-pharmacological as well as experimental and pragmatic pharmacological approaches are outlined to provide a deeper understanding of the best treatment strategy for these patients. Early detection as well as a tailored multidisciplinary approach is necessary to improve symptoms and ultimately the quality of life for patients and their family members.