Psychosis in Parkinson’s disease: ‘between a rock and a hard place’

Abstract

Psychotic symptoms are common in patients receiving treatment for Parkinson's disease. They may be more disabling than the motor symptoms and are associated with a poor prognosis, a problem compounded by the difficulties treatment has traditionally posed. This paper reviews the history of psychosis in Parkinson's disease, its characteristic symptomatology, and some of the theories regarding its pathogenesis. A number of treatment options are examined including the significant advances that atypical neuroleptics have brought to the management of this condition.