How do I manage psychotic symptoms in people with Parkinsons disease?
• Have a low threshold for suspecting psychotic symptoms in people with Parkinson’s disease. • Consider excluding causes besides Parkinson’s disease itself, anti-parkinsonian drugs, and dementia, including: • Delirium caused by other physical illness or drug treatments. • Other comorbid mental illness, such as depression. • Liaise with, and promptly refer to, specialist services all people with Parkinson’s disease who develop psychotic symptoms: • Mild psychotic symptoms may not need to be actively treated if they are well tolerated by the person and carer. • More severe psychotic symptoms may require gradual withdrawal of precipitating anti-parkinsonian medication or the use of an atypical antipsychotic (such as clozapine, under the care of a mental health specialist).
