Almost half of all Parkinson's patients will experience psychiatric complications of one form or another, which could include delusions, according to Hopkins Medicine. Delusions are rigid, false beliefs that are maintained despite evidence to the contrary. Delusions are problematic for Parkinson's patients because they are associated with behavioral disturbances and safety concerns for caregivers, and thus sometimes, anti-psychotic medication is prescribed, notes the National Parkinson's Foundation.
What is Parkinson's Disease
Parkinson's disease is the result of a progressive loss of neurons in the substintia nigra, an important brain area, which results in a decrease in dopamine, an essential neurotransmitter, according Hopkins Medicine. When dopamine levels decrease by 80 percent, the symptoms of the disease become evident, which include a slow and awkward gait, rigid arms and legs, tremor, lack of balance, loss of facial expression and sometimes speech, notes Hopkins Medicine.
Incidence
Over one million people in the United States are afflicted with Parkinson's disease which usually occurs after the age of 65, notes Hopkins Medicine. The National Parkinson's Foundation notes that delusions affect approximately 8 percent of patients Parkinson's patients and that of all types of delusions that are reported, delusions of jealousy and persecution are the most common.
Parkinson's Delusions
Parkinson's Hope Digest explains that some delusions experienced by patients include believing a friend or family member has been replaced by another individual, an impostor or that their house or other familiar things are not authentic, but replicas.
Common delusions for Parkinson's disease patients jealousy or suspicion of their family and friends and it is not uncommon for spouses to be accused of adultery or theft, notes Hopkins Medicine. Additionally, patients can have delusions of persecution, where they believe they are under attack, being cheated or being conspired against, notes the National Parkinson's Foundation.
Causes
Delusions occur more commonly in individuals with advanced disease who are on multiple Parkinson's medications, according to Hopkins Medicine. Parkinson's medication focuses on increasing dopamine in the brain and elevated dopamine levels can trigger psychosis. Unfortunately, it is often side effects of Parkinson's medications that cause the delusions, notes Parkinson's Hope Digest. Parkinson's Medication most likely to result in psychotic side effects like delusions are some anticholinergic medications and some dopamine agonist medications. Other possible causes are delirium and dementia, notes the National Parkinson's Foundation.
Treatment
Delusions can be properly treated only when their cause is ascertained. A clinician must determine if the symptoms are related to medication side effects, dementia or delirium and blood work and other tests may be necessary, notes the National Parkinson's Foundation. If the Parkinson's medication is the causes a clinicians often try adjusting the medication levels or changing medications with the goal being to reduce the psychotic symptoms, but not permit the motor symptoms of the disease to worsen, according to the National Parkinson's Foundation.
Anti-Psychotic Medication
If psychotic symptoms do not improve, or they improve but, motor symptoms become worse after adjusting medications, Parkinson's medications may need to be increased or restarted. In this case, patients can be prescribed anti-psychotic medication, which is designed to balance abnormal chemical levels in the brain by reducing excess dopamine, and therefore, alleviating psychosis, according to the National Parkinson's Foundation.
Using anti-psychotic medication with Parkinson's patients used to be controversial because they often caused a dramatic worsening of the motor symptoms. However, currently, there are two 'atypical' antipsychotics, clozapine and quetiapine, that are considered safe for Parkinson's patients because they treat psychotic symptoms and cause limited worsening of motor symptoms, notes the National Parkinson's Foundation.
