Managing Psychosis in Patients with Parkinson's Disease Managing psychosis is one of the most difficult challenges in the care of patients with Parkinson's disease. This complication occurs in 10 to 15 percent of such patients and consists of visual hallucinations, the belief that one is being persecuted, fears of personal endangerment, or feelings of being followed, spied on, or threatened.
Psychosis is a major source of distress for patients.
It exacerbates the burdens of family members and is associated with earlier transfer to nursing homes and increased mortality. This problem remained unresolved until the recent development of atypical antipsychotic drugs that can control psychotic symptoms without producing extrapyramidal disturbances. There were no deleterious effects with respect to parkinsonism, and tremor was significantly improved in the group receiving clozapine. The study group was reasonably typical of patients with Parkinson's disease and psychosis. All the patients had either new-onset psychosis or recent worsening of symptoms.