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Management of psychotic symptoms in Parkinsons disease

Joseph H Friedman

Parkinsons disease psychosis is a major problem complicating the drug treatment of the motor symptoms of the disease. It is one of the leading causes for nursing home placement, exceeding that of motor dysfunction, and is also a greater stressor for caregivers than motor dysfunction. While there is no approved treatment for this problem, it is important to first exclude medical contributions, such as occult infections, then to reduce psychoactive medications, including the medications for motor symptoms, followed by use of low-dose quetiapine or clozapine, giving the bulk of the dose at bedtime.