[Treatment of psychosis in Parkinson].
BACKGROUND
Parkinson's disease (PD) is a chronic idiopathic neurodegenerative disorder in which there is a dopamine deficit that produces motor and other disturbances, such as autonomic, sensory and neuropsychiatric disorders, including psychosis. Psychosis in PD, which is characterised by the existence of hallucinations and delusions, is a frequent and disabling problem for the patient; it is stressing for caregivers and difficult to manage for the physician, since it predisposes the patient to higher rates of morbidity and mortality and to institutionalisation.


OBJECTIVE
To carry out a review of the literature on the treatment of psychosis in PD.


METHODS
In this paper we review several different aspects of psychosis in PD, such as the diagnostic criteria, pathophysiology, predisposing factors, clinical features and, above all, management, which includes the use of atypical antipsychotics (after attempts have been made to reduce the antiparkinson medication to a limit marked by the loss of motor autonomy). Additionally, we also review the evidence that is currently available on other pharmaceuticals for use to treat psychosis in PD (anticholinesterases, drugs that act on serotonin receptors and so forth).


CONCLUSIONS
Psychosis in PD is a problem that is difficult to treat, with a poorly understood pathophysiology, in which the most important means of combating it (in addition to prevention and reduction of dopaminergic medication, if possible) is the use of atypical antipsychotics. Other treatments which are now offering still very preliminary, but promising, results could well end up becoming the first line of treatment for this condition in the near future.
Durán-Ferreras
E
E
Unidad de Neurología, Servicio de Medicina Interna, Hospital Infanta Elena, Huelva, España. eduardoduranferreras@gmail.com
Chacón
J R
JR
D006801:Humans; D010300:Parkinson Disease / Q000150:complications*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*