TY - JOUR
T1 - Visual hallucinations and the role of medications in parkinson’s disease
T2 - triggers, pathophysiology, and management
AU - Powell, Alice
AU - Ireland, Catriona
AU - Lewis, Simon J. G.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Visual hallucinations, which are part of the syndrome of Parkinson’s disease (PD) psychosis, affect patients’ quality of life and increase the likelihood of residential aged-care placement. The association between visual hallucinations and dopaminergic and other medications that are necessary for the symptomatic management of motor and other symptoms of PD is a common clinical dilemma. While dopaminergic medications have long been associated with PD psychosis, a clear causal link has not been established, and other neurotransmitter systems, particularly noradrenaline, serotonin, and acetylcholine, are implicated and important. A diverse range of demographic and disease-related risk factors, some being modifiable, highlight the complexity of potential underlying pathophysiological processes but also broaden practical options for prevention and treatment that can be multifaceted and individualized. The investigators reviewed the clinical features and epidemiology of visual hallucinations and PD, explored the pathological evidence for dysfunction of multiple neurotransmitter systems that may be relevant to these phenomena, and addressed the potential of medications commonly used in PD to either trigger or treat these symptoms.
AB - Visual hallucinations, which are part of the syndrome of Parkinson’s disease (PD) psychosis, affect patients’ quality of life and increase the likelihood of residential aged-care placement. The association between visual hallucinations and dopaminergic and other medications that are necessary for the symptomatic management of motor and other symptoms of PD is a common clinical dilemma. While dopaminergic medications have long been associated with PD psychosis, a clear causal link has not been established, and other neurotransmitter systems, particularly noradrenaline, serotonin, and acetylcholine, are implicated and important. A diverse range of demographic and disease-related risk factors, some being modifiable, highlight the complexity of potential underlying pathophysiological processes but also broaden practical options for prevention and treatment that can be multifaceted and individualized. The investigators reviewed the clinical features and epidemiology of visual hallucinations and PD, explored the pathological evidence for dysfunction of multiple neurotransmitter systems that may be relevant to these phenomena, and addressed the potential of medications commonly used in PD to either trigger or treat these symptoms.
UR - http://www.scopus.com/inward/record.url?scp=85094919139&partnerID=8YFLogxK
U2 - 10.1176/appi.neuropsych.19110316
DO - 10.1176/appi.neuropsych.19110316
M3 - Article
C2 - 32374649
AN - SCOPUS:85094919139
SN - 0895-0172
VL - 32
SP - 334
EP - 343
JO - Journal of Neuropsychiatry and Clinical Neurosciences
JF - Journal of Neuropsychiatry and Clinical Neurosciences
IS - 4
ER -