Manage psychosis in Parkinson’s disease using a stepwise approach

Abstract

Psychosis in Parkinson’s disease arises from complex interactions involving numerous endogenous and exogenous risk factors associated with pathophysiology and can pose a considerable management challenge. The identification of patients at heightened risk of psychosis is important for the prevention and management of this complication. Psychosis in Parkinson’s disease should be treated using a stepwise approach, as psychotic symptoms may be resolved without the addition of specific antipsychotic therapies. Medications available for the specific treatment of psychotic symptoms in Parkinson’s disease, without significantly worsening of motor symptoms, include clozapine, quetiapine, pimavanserin, rivastigmine and donepezil.