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Parkinson's disease psychosis: presentation, diagnosis and management

    Ruth B Schneider

    Department of Neurology, University of Rochester School of Medicine & Dentistry, 265 Crittenden Blvd, Box MIND, Rochester, NY 14642, USA

    ,
    Julia Iourinets

    Department of Neurology, University of Rochester School of Medicine & Dentistry, 919 Westfall Rd, Bldg C, Rochester, NY 14618, USA

    &
    Irene H Richard

    *Author for correspondence:

    E-mail Address: Irene_richard@urmc.rochester.edu

    Department of Neurology, University of Rochester School of Medicine & Dentistry, 919 Westfall Rd, Bldg C, Rochester, NY 14618, USA

    Published Online:https://doi.org/10.2217/nmt-2017-0028

    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.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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