ReviewParkinson’s disease psychosis 2010: A review article☆
Section snippets
Psychosis and psychotic symptoms
The term “psychosis” has been replaced in recent years by the term “psychotic syndrome,” in which patients show signs of specific psychotic symptoms [1]. The older definition used “loss of reality testing” as the primary determinant. In the case of people with Parkinson’s disease (PD) the predominant symptoms are hallucinations and delusions [2], [3], [4], [5], [6]. Hallucinations are sensory phenomena that are not induced by physical stimuli. These occur in each sensory modality: visual,
Conclusion
Psychotic symptoms are common in PD, and although they may appear in the absence of medication [13], [15] primarily develop in patients who take medications to improve mobility, at least in the financially developed world. The psychotic symptoms are predominantly hallucinations, with visual being the most common, followed by auditory, and are quite stereotypic and fixed for each individual. Delusions are the next most common symptom, and these too are stereotypic, being mostly paranoid, in
Conflict of interest
Conflicts of interest last 12 months: Teva, Acadia Pharmaceuticals, EMD Serono, Glaxo Smith Kline, Ingelheim-Boehringer, Cephalon, NIH, MJ Fox Foundation.
Conflicts of interest in last 10 years include manufacturers of each atypical anti-psychotic drug as a consultant: Astra Zeneca, Novartis, Bristol Myers Squibb, Eli Lilly, Pfizer, Ovation.
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Cited by (83)
Efficacy results of pimavanserin from a multi-center, open-label extension study in Parkinson's disease psychosis patients
2021, Parkinsonism and Related DisordersPrinciples and Practice of Movement Disorders
2021, Principles and Practice of Movement DisordersLong-term evaluation of open-label pimavanserin safety and tolerability in Parkinson's disease psychosis
2020, Parkinsonism and Related DisordersCitation Excerpt :Once symptoms of Parkinson's disease psychosis (PDP) emerge, they almost always progress, and often affect treatment decisions including medications needed for control of motor symptoms. The onset and progression of psychotic symptoms are linked to increased dementia, morbidity, and mortality [5], and poorly controlled PDP is a major risk factor for premature nursing home placement and mortality [6–8]. Mixed receptor antipsychotics, which are frequently used off-label to treat PDP, are associated with worsening of PD motor symptoms as well as orthostatic hypotension, sedation, stroke, hematologic disorder, cardiovascular events, and sudden death in the elderly [9–13].
Dementias and the Frontal Lobes
2017, Executive Functions in Health and DiseaseImaging the Nonmotor Symptoms in Parkinson's Disease
2017, International Review of NeurobiologyCitation Excerpt :In contrast, a postmortem tissue study, investigating 5-HT1A receptor binding, found no association with the psychosis spectrum, though an elevation of 5-HT1A receptor binding was observed in PD patients, irrespective of hallucination status, in sublayers of orbito-frontal, ventral temporal, and motor cortex (Huot et al., 2012). The D2 antagonist effect of typical and atypical antipsychotics complicates the treatment of psychosis in PD, as they may worsen motor and cognitive symptoms (Friedman, 2010; Marsh, 2004). Evidence has been suggestive of the serotonergic system contributing to the pathophysiology of psychosis in PD (Fenelon, 2008; Zahodne & Fernandez, 2008).
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The review of this paper was entirely handled by the Co-Editor-in-Chief, Zbigniew Wszolek.