Psychotic symptoms in Parkinson's disease : From description to etiology

Psychotic symptoms are common in Parkinson's disease (PD) and occur in at least 20% of medication-treated patients. Benign visual hallucinations usually appear earlier, while malignant hallucinations, confusional states, delusions, paranoid beliefs, agitation, and delirium become more frequent...

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Bibliographic Details
Published in:Journal of neurology 2005-07, Vol.252 (7), p.753-764
Main Authors: PAPAPETROPOULOS, Spiridon, MASH, D. C
Format: Article
Language:English
Subjects:
Animals
Antiparkinson Agents - therapeutic use
Behavioral Symptoms - drug therapy
Behavioral Symptoms - epidemiology
Behavioral Symptoms - etiology
Behavioral Symptoms - metabolism
Biological and medical sciences
Brain Chemistry - physiology
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Parkinson Disease - drug therapy
Parkinson Disease - epidemiology
Parkinson Disease - physiopathology
Prevalence
Psychotic Disorders - drug therapy
Psychotic Disorders - epidemiology
Psychotic Disorders - etiology
Psychotic Disorders - metabolism
Risk Factors
Citations: Items that this one cites
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Summary:Psychotic symptoms are common in Parkinson's disease (PD) and occur in at least 20% of medication-treated patients. Benign visual hallucinations usually appear earlier, while malignant hallucinations, confusional states, delusions, paranoid beliefs, agitation, and delirium become more frequent with disease progression. Virtually all antiparkinsonian drugs may produce psychotic symptoms. Cognitive impairment, increased age, disease duration and severity, depression, and sleep disorders have been consistently identified as independent risk factors for their development. Although the precise pathoetiologic mechanisms remain unknown, we review evidence that links ventral dopaminergic pathway dysfunction (overactivity) together with the involvement of other neurotransmitter system imbalances as likely contributors. The clinical importance of the proposed mechanism is that successful management of psychotic symptoms in PD may rely on a multitarget approach to restore neurotransmitter imbalances rather than focusing exclusively on the dopaminergic dysfunction.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-005-0918-5