Summary:
Psychosis in patients suffering from Parkinson’s disease (Parkinson Disease
Psychosis - PDP) is a late and frequent complication, related with poor
prognosis and significant burden in quality of life. The conventional
antiparkinsonian drugs seem to induce or aggravate psychotic symptoms, thus
defining the management of these patients as a great challenge. This article
review presents the current treatment options in PDP. Clozapine in low doses is
considered as an evidence-based treatment in PDP, but a close blood screening
is needed and that fact diminishes its clinical use. Quetiapine seems a usefull
and safe treatment, despite it is not as well-established as Clozapine. Lack of
efficacy of the other antipsychotics, shifts the research in specific
serotoninergic agents (5ΗΤ2Α,2C,3 inhibitors). Mirtazapine and Ondansetrone
probably improve the psychotic symptoms but these results come from small
samples. On the other hand, Pimavanserine is in approval process by FDA,
suggesting a novel field of research in the near future. Finally,
electroconvulsive treatment shows benefits in small case report studies of
patients with medically refractory PDP.
Keywords:
Parkinson, Psychosis, Hallucinations, Antipsychotics, Treatment
