Psychosis in patients with Parkinson’s disease (PD) is a common and important problem. It is a frequent cause of nursing home placement and is associated with a high mortality. The cause of psychosis in PD is usually multi-factorial but often involves the agents used to treat the motor symptoms of the disease. Treatment strategies should include ruling out other causes of cognitive decline, reducing anti-PD medications, and judicious use of atypical neuroleptic medications. Cholinesterase inhibitors can also be useful as an adjunctive agent in patients with psychosis and cognitive decline. Careful management of PD patients with psychosis can often result in good control of hallucinations and delusions without significant decline in motor function.
