Parkinson's disease psychosis: presentation, diagnosis and management

Neurodegener Dis Manag. 2017 Dec;7(6):365-376. doi: 10.2217/nmt-2017-0028. Epub 2017 Nov 21.


Parkinson's disease is a neurodegenerative disorder characterized by motor and nonmotor symptoms. Psychosis is a common feature of Parkinson's disease. Parkinson's disease psychosis (PDP) encompasses minor phenomena (illusions, passage hallucinations and presence hallucinations), visual and nonvisual hallucinations and delusions. PDP is associated with reduced function and quality of life. The initial management approach should focus on identification and treatment of any contributory medical factors, reduction or discontinuation of medications with potential to induce or worsen psychosis, nonpharmacological strategies and consideration of acetylcholinesterase inhibitor treatment in the setting of dementia. Pimavanserin, quetiapine and clozapine may all be considered for use in PDP. In this review, we discuss the presentation, diagnosis and management of PDP.

Keywords: Parkinson's disease; antipsychotic; delusions; hallucinations; pimavanserin; psychosis.

Publication types

  • Review

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Humans
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / psychology
  • Parkinson Disease / therapy*
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / etiology
  • Psychotic Disorders / physiopathology
  • Psychotic Disorders / therapy*
  • Psychotropic Drugs / therapeutic use


  • Antiparkinson Agents
  • Psychotropic Drugs