Psychosis in Parkinson Disease (PDP) is a common clinical problem and presents a pharmacological
therapeutic conundrum. Many patients with PDP require anti-parkinsonian drugs for motor control, but the use of these
medications has been associated with worsening of the psychotic symptoms. Differences from other psychotic disorders
include the association with the use of anti-parkinsonian drugs, and the common presentation with visual hallucinations.
Understanding of the pathophysiology of this phenomenon in PD has grown over the last few decades with the realization
that the dopaminergic system is not the sole player. This has led to pharmacological research beyond antipsychotics. In
this article we review the general management of PDP, the available evidence for the pharmacological management of
PDP, and the medications profile and safety. Useful tables, practical recommendations and treatment algorithm are
Keywords: Atypical antipsychotics, cholinesterase inhibitors, dopamine agonists, levodopa, parkinson disease, psychosis,
psychosis in parkinson disease, review, side effects.
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