Global Neurology Academy

Psychosis: An Overlooked Manifestation of Parkinson’s Disease?

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%...

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  • Overview

    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.

    References
    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.

  • Provider(s)/Educational Partner(s)

    This activity is jointly provided by Medical Education Resources and CMEology. 

      

  • Commercial Support

    This activity is supported by an educational grant from ACADIA Pharmaceuticals Inc.

  • Target Audience

    This activity has been designed to meet the needs of neurologists, psychiatrists, nurse practitioners, and registered nurses who are involved in the management and treatment of patients with Parkinson’s disease.

  • Learning Objectives

    Program Agenda
    Psychosis: An Overlooked Manifestation of Parkinson’s Disease? 

    • Parkinson’s Disease: Introduction
    • Parkinson’s Disease Psychosis
    • Phenomenology: Hallucinations and Delusions
    • NINDS-NIMH Diagnostic Criteria
    • Pathophysiology and Clinical Course
    • Treatments 
    • Conclusions

    Learning Goal
    The goal of this symposium is to educate health care providers on the latest information in the area of PD-related psychosis.

    Educational Objectives
    After completing this activity, the participant should be better able to:

    • Review the epidemiology and risk factors for psychosis and psychiatric symptoms in PD
    • Differentiate the presentation of psychiatric symptoms in PD from that of motor symptoms
    • Identify specific screening tools to identify PD psychosis in its early stages
    • Enhance patient and caregiver evaluations to overcome barriers that may prevent them from disclosing psychiatric symptoms
    • Assess available treatment approaches for psychiatric manifestations of PD
  • Disclosure of Conflicts of Interest

    Faculty
    Stuart H. Isaacson, MD
    Director
    Parkinson’s Disease and Movement Disorders Center of Boca Raton
    Associate Professor of Neurology
    Florida International University
    Herbert Wertheim College of Medicine
    Boca Raton, Florida

    Henry A. Nasrallah, MD
    The Sydney W. Souers Professor and Chair
    Department of Neurology and Psychiatry
    Saint Louis University School of Medicine
    St. Louis, Missouri

    Disclosure of Conflicts of Interest
    Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality activities that promote improvements or quality in health care and not the business interest of a commercial entity

    The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

    • Stuart H. Issacson, MDConsulting Fees, Grants/Research Support, and/or Speakers’ Bureau/Other Lectures on behalf of: Abbvie Inc., ACADIA Pharmaceuticals Inc., Adamas Pharmaceuticals, Inc., Addex Therapeutics, Allergan, Allon Therapeutics, Inc., Amarantus Bioscience Holdings, Inc., AstraZeneca, Auspex Pharmaceuticals, Biotie Therapies, Britannia Pharmaceuticals Ltd., Chelsea Therapeutics International, Ltd., Civitas Therapeutics, Inc., Cynapsus Therapeutics Inc., Eisai Co., Ltd., Eli Lilly and Company, EMD Serono, Inc., F. Hoffmann-La Roche Ltd., GE Healthcare, GlaxoSmithKline plc., H. Lundbeck A/S, Impax Pharmaceuticals, Ipsen Group, Kyowa Pharma Chemical Co., Medtronic, Merck & Co., Merz Pharma, Michael J. Fox Foundation, National Institutes of Health, Neurocrine Biosciences, Inc., Novartis AG, Orion Corporation, Parkinson Study Group, Pfizer Inc., Phytopharm, Purdue Pharma L.P., Santhera Pharmaceuticals, Shire, Teva Pharmaceutical Industries Ltd., UCB S.A., US WorldMeds, LLC., Vanda Pharmaceuticals, XenoPort, Inc.
    • Henry A. Nasrallah, MDConsulting Fees, Grants/Research Support, and/or Speakers’ Bureau/Other Lectures on behalf of: ACADIA Pharmaceuticals Inc., Alkermes, Boehringer Ingelheim GmbH, FORUM Pharmaceuticals, Janssen Pharmaceuticals, Inc., Otsuka America Pharmaceutical, Inc., Sunovion Pharmaceuticals, Inc., Vanda Pharmaceuticals.

    The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

    • Rob Lowney (CMEology) No financial relationships to disclose.
    • Dana Ravyn, PhD, MPH (CMEology) No financial relationships to disclose.
    • Rachael Soranno (CMEology) No financial relationships to disclose.
    • Julie Johnson, PharmD (MER) No financial relationships to disclose.
    • Veronda Smith, FNP-BC (MER) No financial relationships to disclose.
  • Accreditation and Credit Designation Statements

    Physician Credit

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Medical Education Resources (MER) and CMEology. MER is accredited by the ACCME to provide continuing medical education for physicians.

    Credit Designation

    Medical Education Resources designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Nursing Credit

    Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. 

    This CE activity provides 1.0 contact hour of continuing nursing education. 

    Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1.0 contact hour.

  • Instructions

    Method of Participation
    There are no fees for participating in and receiving credit for this activity. During the period TBD through TBD participants must 1) read the educational objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question, and 4) complete the evaluation form.

    A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

    Medical Education Resources: 303-798-9682

  • Disclaimer

    The content and views presented in this educational activity are those of the faculty and do not necessarily reflect those of Medical Education Resources, CMEology, and/or ACADIA Pharmaceuticals Inc. The faculty have disclosed if there is any discussion in their presentations of published and/or investigational uses of agents that are not indicated by the FDA. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

    Fee Information
    There is no fee for this educational activity.

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