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geri:parkinsons [on May 25, 2026]
psychdb [Psychosis] 		geri:parkinsons [on May 25, 2026] (current)
psychdb [Psychosis]
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     * PD psychosis has unique clinical features, in that patients are usually aware and have insight.     * PD psychosis has unique clinical features, in that patients are usually aware and have insight.
     * Parkinson'​s psychosis is a poor prognostic factor, and there is a higher risk for weight loss, caregiver burden, placement, and death.[([[https://​pubmed.ncbi.nlm.nih.gov/​12796526/​|Factor,​ S. A., Feustel, P. J., Friedman, J. H., Comella, C. L., Goetz, C. G., Kurlan, R., ... & Parkinson Study Group. (2003). Longitudinal outcome of Parkinson’s disease patients with psychosis. Neurology, 60(11), 1756-1761.]])]     * Parkinson'​s psychosis is a poor prognostic factor, and there is a higher risk for weight loss, caregiver burden, placement, and death.[([[https://​pubmed.ncbi.nlm.nih.gov/​12796526/​|Factor,​ S. A., Feustel, P. J., Friedman, J. H., Comella, C. L., Goetz, C. G., Kurlan, R., ... & Parkinson Study Group. (2003). Longitudinal outcome of Parkinson’s disease patients with psychosis. Neurology, 60(11), 1756-1761.]])]
-  * The use of Parkinson'​s medications (particularly [[meds:​dopamine-agonists:​home|dopamine receptor agonists]]) has been the most widely identified risk factor for psychosis. The psychosis most commonly involves visual hallucinations,​ which progresses over time. Other symptoms may include auditory hallucinations,​ delusions, and illusions.+  * The use of Parkinson'​s medications (particularly [[meds:​dopamine-agonists:​home|dopamine receptor agonists]]) has been the most widely identified risk factor for psychosis. The psychosis most commonly involves visual hallucinations,​ which progresses over time.  
 +    * Other symptoms may include auditory hallucinations,​ delusions, and illusions.
   * **Anticholinesterase inhibitors** are the first line of treatment of psychosis, with [[meds:​dementia:​rivastigmine|rivastigmine]] having the most evidence, followed by [[meds:​dementia:​donepezil|donepezil]].[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​18665659|Zahodne,​ L. B., & Fernandez, H. H. (2008). Pathophysiology and treatment of psychosis in Parkinson’s disease. Drugs & aging, 25(8), 665-682.]])] ​   ​   * **Anticholinesterase inhibitors** are the first line of treatment of psychosis, with [[meds:​dementia:​rivastigmine|rivastigmine]] having the most evidence, followed by [[meds:​dementia:​donepezil|donepezil]].[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​18665659|Zahodne,​ L. B., & Fernandez, H. H. (2008). Pathophysiology and treatment of psychosis in Parkinson’s disease. Drugs & aging, 25(8), 665-682.]])] ​   ​
   * [[meds:​antipsychotics:​second-gen-atypical:​7-clozapine|Clozapine]] is the most effective treatment for Parkinson'​s-related psychosis,​[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​16606910|Miyasaki,​ J. M., Shannon, K., Voon, V., Ravina, B., Kleiner-Fisman,​ G., Anderson, K., ... & Weiner, W. J. (2006). Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 66(7), 996-1002.]])] and should be used if patients can tolerate the required blood monitoring.   * [[meds:​antipsychotics:​second-gen-atypical:​7-clozapine|Clozapine]] is the most effective treatment for Parkinson'​s-related psychosis,​[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​16606910|Miyasaki,​ J. M., Shannon, K., Voon, V., Ravina, B., Kleiner-Fisman,​ G., Anderson, K., ... & Weiner, W. J. (2006). Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 66(7), 996-1002.]])] and should be used if patients can tolerate the required blood monitoring.