ABSTRACT
Psychotic symptoms occur in up to one-half of patients with Parkinson’s
disease (PD). Treating psychosis is often challenging since antiparkinsonian
medications contribute to psychopathology, antipsychotic medications can
aggravate motor and cognitive impairments, and the patients tend to have
advanced-stage PD with its attendant motor complications, dementia,
medical and other psychiatric co-morbidities, and increased caregiver
strain.1,2 Even though prognosis has improved with use of atypical anti-
psychotics, psychosis is the most important risk factor for nursing home
placement in PD3 and is associated with increased mortality.4 This chapter
reviews the phenomenology, pathophysiology, and treatments of psychosis
in PD. It emphasizes awareness of the various presentations of psychosis,
attention to modifiable risk factors, and application of a variety of treatment
strategies with knowledge of how these impact motor function and drug
interactions.
