Treating Hallucinations and Delusions Associated With Parkinson's Disease Psychosis

Curr Psychiatry Rep. 2018 Jan 27;20(1):3. doi: 10.1007/s11920-018-0869-z.

Abstract

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.

Keywords: Antipsychotic; Delusions; Hallucinations; Parkinson’s disease; Pimavanserin; Psychosis.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Delusions / drug therapy*
  • Delusions / etiology
  • Hallucinations / drug therapy*
  • Hallucinations / etiology
  • Humans
  • Parkinson Disease / complications*
  • Parkinson Disease / psychology
  • Piperidines / therapeutic use
  • Psychotic Disorders / drug therapy*
  • Serotonin 5-HT2 Receptor Antagonists / therapeutic use*
  • Urea / analogs & derivatives
  • Urea / therapeutic use

Substances

  • Antipsychotic Agents
  • Piperidines
  • Serotonin 5-HT2 Receptor Antagonists
  • Urea
  • pimavanserin