Patients with Parkinson's disease have problems with movement as a result of a dopamine deficiency. They can also have hallucinations, in which they hear, see or feel things that aren't there. These hallucinations can result from the medications used to treat the disorder, progression of Parkinson's disease and other factors. There may be a need for treatment.
Changes to Medication Regimen
Because certain Parkinson's disease medications can cause hallucinations, doctors may need to make adjustments. This change can become difficult, as patients need these medications to move. Babak Tousi, M.D. and Thayagaran Subramanian, M.D., authors of the article “Hallucinations in Parkinson's Disease: Approach and Management,” explain that doctors can change or eliminate certain medications. For example, if a patient has hallucinations, she should stop taking medications for other conditions that have hallucinations as a common side effect, such as H2 blockers, which treat acid reflux. After eliminating these medications, the authors suggest reducing the dosage or number of medications taken at night, which can help with nighttime hallucinations. If patients still have hallucinations, doctors can reduce the dosage or stop giving patients selegiline, amantadine and anticholinergics, medications that specifically treat Parkinson's disease. Under a doctor's supervision, patients can stop taking selegiline suddenly, although they need a gradual withdrawal from amantadine and anticholinergics. The Parkinson's Disease Society warns that changing these medications may or may not improve hallucinations.
Antipsychotic Medications
If the hallucinations don't improve by changing the dosage of the Parkinson's disease medications, patients may need to take antipsychotic medications. Though these medications can treat the hallucinations, they can worsen symptoms of Parkinson's disease because they decrease the amount of dopamine in the brain. The Parkinson's Disease Society explains that two types of antipsychotics exist: conventional antipsychotics and atypical antipsychotics. Each type of antipsychotic causes different effects on Parkinson's disease. Although chlorpromazine and haloperidol, two types of conventional antipsychotics, treat the hallucinations, they can seriously worsen symptoms of Parkinson's. Two other conventional antipsychotics, sulpiride and thioridazine, only moderately worsen Parkinson's disease.
Atypical antipsychotics tend to have lesser side effects, but not all Parkinson's disease patients can take them for hallucinations. For example, doctors must be careful when prescribing olanzapine or risperidone for patients at risk for a stroke, as these drugs may cause cardiovascular problems. Quetiapine doesn't affect Parkinson's disease much. Clozapine usually doesn't make Parkinson's disease symptoms worse, but the Parkinson's Disease Society says it may result in serious bone marrow toxicity.
Treating Other Conditions
The Parkinson's Disease Society says some Parkinson's patients may have hallucinations as a result of another disease, such as a bladder infection. Treating this other condition can treat the hallucinations. For example, the Merck Manual Home Edition notes that antibiotics can treat a bladder infection, which may also treat the hallucinations.
