Statement of Need/Program Overview
Psychotic symptoms are a frequent complication of Parkinson’s disease (PD) and may affect as many as 50% to 75% of patients with PD.1,2 Despite their prevalence, psychiatric manifestations have been an overlooked and poorly understood aspect of PD management. Worsening psychotic symptoms greatly complicate the care of a person with PD and can add to caregiver stress. There is evidence that physicians and other health care providers may be unaware of the prevalence and risk factors for PD-related psychosis and, therefore, may not evaluate and screen patients to detect early signs and symptoms.3 Health care providers need a greater awareness of the magnitude of this problem among patients with an existing diagnosis of PD or in those who later develop the disease. Even without psychotic symptoms, the treatment of PD involves a complex balance of managing motor symptoms while minimizing dyskinesia and other adverse effects of medications. Although PD-related psychosis is often treated with antipsychotic medications, these can worsen motor dysfunction.4 Recent research has explored newer medications for psychiatric manifestations of PD, but providers may be unfamiliar with their mechanisms. In this activity, expert faculty will discuss the risk factors, early detection, and differentiation of psychiatric symptoms in patients with PD, as well as strategies for current and emerging pharmacologic management approaches.
1. Forsaa EB, Larsen JP, Wentzel-Larsen T, et al. A 12-year population based study of psychosis in Parkinson disease. Arch Neurol. 2010;67(8):996-1001.
2. Williams DR, Warren JD, Lees AJ. Using the presence of visual hallucinations to differentiate Parkinson’s disease from atypical parkinsonism. J Neurol Neurosurg Psychiatry. 2008;79(6):652-655.
3. Goetz CG, Stebbins GT, Ouyang B. Visual plus nonvisual hallucinations in Parkinson’s disease: development and evolution over 10 years. Mov Disord. 2011;26(12):2196-2200.
4. Goldman JG, Holden S. Treatment of psychosis and dementia in Parkinson’s disease. Curr Treat Options Neurol. 2014;16(3):281.