APDA American Parkinson Disease Association
Information & Referral Center

Psychosis in PD

Psychosis refers to hallucinations and delusions.

Visual hallucinations are the most common type of hallucination. This is where someone sees things that are not actually there. There can also be auditory and olfactory hallucinations. Often hallucinations are not alarming to the person experiencing them.

Delusions are where there is an alternate view of reality: an entire irrational story is created. Paranoia is a common type of delusion.


Relevant Publications - Downloadable

“Hallucinations and Delusions in PD,” by David Burn and Marjan Jarhanshahi
Published by Parkinson’s UK, May 2013
This 5-page information sheet has a good general description of common hallucinations and delusions experienced by those impacted by Parkinson’s as well as possible causes and treatment options.

 

“Psychosis: A Mind Guide to Parkinson’s,” by Linda Minton, Kate Perepezko, and Gregory Pontone, MD
Published by National Parkinson Foundation (Now the Parkinson's Foundation) Can be ordered from NPF online store.
This 40-page booklet is a thorough guide to all aspects of Parkinson’s psychosis, including symptoms, causes, treatment options and coping strategies for both the family and person experiencing the psychosis.

 


Relevant Online Information

“Hallucinations/Delusions”
Published by the National Parkinson Foundation (Now the Parkinson's Foundation)
This webpage provides information on the differences between hallucinations, delusions, delirium, dementia; risk factors, causes and treatment options for each as well as some coping strategies for family members and care partners when dealing with one or more disorder.

 

“Parkinson’s Disease Psychosis,” by Maria Joao Almeida
Published by Parkinson’s News Today
A short webpage explains the difference between hallucinations and delusions, the frequency of psychosis in Parkinson’s disease, the diagnostic process and treatment through adjusting dopamine and anti-psychotic agents.

 

“Psychosis in Parkinson’s,” by Mosaic Science
Published by the Caregiver Space, March 17, 2017
This blog post shares the experience at least half of people diagnosed with Parkinson’s - developing Parkinson’s disease psychosis (PDP).  It further shares the impact on those treated by the newly approved, Nuplazid, the first drug to specifically treat delusions and hallucinations associated with PDP.

 

“Psychosis in PD (PDP),” by Dr. Maria De Leon
By defeatparkinsons.com, February 7, 2017
In this blog post, the author states that psychosis is the highest cause of caregiver burden and stress, leads to significant disability and poor quality of life, and the risk increases with disease duration.  Dr. De Leon lists many causes of underlying neuropsychiatric disturbances possible in PD, and causes of psychosis common to the elderly.

 


Relevant Online Lectures and Webinars

“Demystifying Hallucinations, Night Terrors and Dementia in Parkinson’s”
By Benevilla and the Parkinson’s Disease Foundation, May 21, 2013
Recording of audio (requires registration)
This two-hour webinar (slightly dated) includes extensive discussion about hallucinations, delusions, illusions and other examples of Parkinson’s psychosis (as well as  discussions about PD Dementia and sleep disorders) in Parkinson's. Presenters: Rohit Dhall, MD, MSPH (he was at the Muhammed Ali Parkinson's Center in 2013, currently Director of Neurodegenerative Disorders, University of Arkansas for Medical Sciences) and Vergilio Gerald H. Evidente, Director, Movement Disorders Center of Arizona in Scottsdale .Pay particular attention to Dr. Rohit Dhall’s description of the causes of PD psychosis (and the difference with other psychoses) as well as treatment options and what to discuss with your movement disorder specialist. Dr. Evidente gives a clear description on differences in PD dementia, Alzheimer's and other dementias.

 

“Hallucinations and Parkinson’s with Dr. Friedman”
By the Parkinson’s Disease Foundation (Now the Parkinson’s Foundation), December 13, 2017
This 16-minute video is a series of interviews with Parkinson’s patients who experience hallucinations interspersed with comments by Dr. Friedman about the causes of hallucinations in Parkinson’s disease, how to cope with them as a caregiver, communicating with your neurologist and medication adjustments to diminish hallucinations.

 

“Treating Parkinson’s Hallucinations and Delusions”
By the Michael J. Fox Foundation, May 19, 2016
This 1-hour webinar is a discussion of Parkinson’s psychosis; prevalence within the Parkinson’s community (more than half of those with PD may experience one of the major symptoms); how it develops; and how it can be treated without impacting motor symptoms. The focus is on a new treatment option and family dynamics while dealing with Parkinson’s psychosis. Preregistration required before viewing.

 


Expert-Level Resources

“A Review of the Pathophysiology and Treatment of Psychosis in Parkinson’s Disease,” by Laura B. Zahodne and Hubert H. Fernandez
Drugs Aging, 2008, vol. 25, no. 8, pages 665-682
A thorough description of the underlying causes of psychosis in Parkinson’s with links to many other studies focusing on particular presentations of disorders or treatment options for these disorders.

 


This list last updated by Denise Dagan, November 2017. Initially compiled by Steven Russell, Stanford Parkinson's Community Outreach, February 2017

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