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Rivastigmine for Behavioural Symptoms in Parkinson's Disease: Evidence and Open Questions
1Department of Medicine and Surgery, Kore University of Enna, Enna, Italy.
Human Psychopharmacology
|May 15, 2026
Summary
Rivastigmine may help Parkinson's disease (PD) patients with hallucinations, though its effect on apathy is unclear. Further research is needed to confirm these findings for behavioral symptoms in PD.
Area of Science:
- Neurology
- Pharmacology
Background:
- Parkinson's disease (PD) frequently presents with behavioral symptoms like hallucinations, apathy, and depression.
- Neuropsychiatric symptoms significantly impact the quality of life for PD patients.
Purpose of the Study:
- To evaluate the effectiveness of rivastigmine in managing neuropsychiatric symptoms in Parkinson's disease.
- To synthesize current evidence on rivastigmine's role in treating behavioral disturbances in PD.
Main Methods:
- A systematic literature search was conducted across PubMed, MEDLINE, and EBSCO databases.
- Studies published between January 1, 2000, and October 1, 2025, focusing on Parkinson's disease and rivastigmine interventions were included.
- Case reports and case series were excluded to maintain study quality.
Main Results:
- Eight studies, including five randomized controlled trials and three open-label studies, were analyzed.
- Rivastigmine demonstrated improvement in hallucinations across most included studies.
- The impact of rivastigmine on apathy showed mixed results, indicating further investigation is required.
Conclusions:
- Rivastigmine shows potential for improving hallucinations in select Parkinson's disease patients.
- Clinical practice suggests rivastigmine is beneficial for behavioral disturbances, especially in patients with cognitive impairment.
- High-quality, multicenter randomized controlled trials are necessary to further validate rivastigmine's efficacy and optimal use in PD.
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