Journal of Neurology

, Volume 252, Issue 7, pp 753–764

Psychotic symptoms in Parkinson’s disease

From description to etiology


Psychotic symptoms are common in Parkinson’s disease (PD) and occur in at least 20% of medication-treated patients. Benign visual hallucinations usually appear earlier, while malignant hallucinations, confusional states, delusions, paranoid beliefs, agitation, and delirium become more frequent with disease progression. Virtually all antiparkinsonian drugs may produce psychotic symptoms. Cognitive impairment, increased age, disease duration and severity, depression, and sleep disorders have been consistently identified as independent risk factors for their development. Although the precise pathoetiologic mechanisms remain unknown, we review evidence that links ventral dopaminergic pathway dysfunction (overactivity) together with the involvement of other neurotransmitter system imbalances as likely contributors. The clinical importance of the proposed mechanism is that successful management of psychotic symptoms in PD may rely on a multitarget approach to restore neurotransmitter imbalances rather than focusing exclusively on the dopaminergic dysfunction.

Key words

Parkinson’s disease psychotic symptoms hallucinations etiology 


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  1. 1.
    Aarsland D, Ballard C, Larsen JP, et al. (2001) A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson’s disease with and without dementia. Int J Geriatr Psychiatry 16(5):528–536PubMedGoogle Scholar
  2. 2.
    Aarsland D, Larsen JP, Cummins JL, et al. (1999) Prevalence and clinical correlates of psychotic symptoms in Parkinson disease: a community-based study. Arch Neurol 56(5):595–601PubMedGoogle Scholar
  3. 3.
    American Psychiatric Association, Diagnostic and Statistical Manual for Psychiatric Disorders (1987) Revised third edition, ed. American Psychiatric Association. Washington, DCGoogle Scholar
  4. 4.
    American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 4th edn. 1994, Washington DCGoogle Scholar
  5. 5.
    Arnulf I, Bonnet AM, Damier P, et al. (2000) Hallucinations, REM sleep, and Parkinson’s disease: a medical hypothesis. Neurology 55(2):281–288PubMedGoogle Scholar
  6. 6.
    Baker MG (1999) Depression, psychosis and dementia in Parkinson’s disease. Neurology 52(7 Suppl 3):S1PubMedGoogle Scholar
  7. 7.
    Ballard CG, Aarsland D, McKeith I, et al. (2002) Fluctuations in attention: PD dementia vs DLB with parkinsonism. Neurology 59(11):1714–1720PubMedGoogle Scholar
  8. 8.
    Barclay CL, Hildebrand K, Gray P, et al. (1997) Risk factors for the development of psychosis in Parkinson’s disease. Mov Disord 12(Suppl 1):S108Google Scholar
  9. 9.
    Barnes J, David AS (2001) Visual hallucinations in Parkinson’s disease: a review and phenomenological survey. J Neurol Neurosurg Psychiatry 70(6):727–733PubMedGoogle Scholar
  10. 10.
    Bergman J, Lerner V (2002) Successful use of donepezil for the treatment of psychotic symptoms in patients with Parkinson’s disease. Clin Neuropharmacol 25(2):107–110PubMedGoogle Scholar
  11. 11.
    Betarbet R, Greenamyre JT (2004) Regulation of dopamine receptor and neuropeptide expression in the basal ganglia of monkeys treated with MPTP. Exp Neurol 189(2):393–403PubMedGoogle Scholar
  12. 12.
    Birkmayer W, Riederer P (1975) Responsibility of extrastriatal areas for the appearance of psychotic symptoms (clinical and biochemical human postmortem findings). J Neural Transm 37(2):175–182PubMedGoogle Scholar
  13. 13.
    Brandt J, Spencer M, Folstein MF (1988) The telephone interview for cognitive status. Neuropsychiatry Neuropsychol Behav, pp 111–117Google Scholar
  14. 14.
    Brink TL, Rose TL, Lum O (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49Google Scholar
  15. 15.
    Bullock R, Cameron A (2002) Rivastigmine for the treatment of dementia and visual hallucinations associated with Parkinson’s disease: a case series. Curr Med Res Opin 18(5):258–264PubMedGoogle Scholar
  16. 16.
    Burn DJ, Troster AI (2004) Neuropsychiatric complications of medical and surgical therapies for Parkinson’s disease. J Geriatr Psychiatry Neurol 17(3):172–180PubMedGoogle Scholar
  17. 17.
    Celesia GG, Barr AN (1970) Psychosis and other psychiatric manifestations of levodopa therapy. Arch Neurol 23(3):193–200PubMedGoogle Scholar
  18. 18.
    Comella CL, Nardine TM, Diederich NJ, et al. (1998) Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology 51(2):526–529PubMedGoogle Scholar
  19. 19.
    Comella CL, Tanner CM, Ristanovic RK (1993) Polysomnographic sleep measures in Parkinson’s disease patients with treatment-induced hallucinations. Ann Neurol 34(5):710–714PubMedGoogle Scholar
  20. 20.
    Cummings JL (1992) Neuropsychiatric complications of drug treatment of Parkinson’s disease in Parkinson’s Disease. In: Huber SJ, Cumming JL (eds) Neurobehavioral Aspects. Oxford University Press: New York, pp 313–327Google Scholar
  21. 21.
    de Smet Y, Ruberg M, Serdaru M, et al. (1982) Confusion, dementia and anticholinergics in Parkinson’s disease. J Neurol Neurosurg Psychiatry 45(12):1161–1164PubMedGoogle Scholar
  22. 22.
    Cummings JL (1992) Neuropsychiatric complications of drug treatment of Parkinson’s disease in Parkinson’s Disease. In: Huber SJ, Cumming JL (eds) Neurobehavioral Aspects.Oxford University Press: New York, pp 313–327Google Scholar
  23. 23.
    Doe De Maindreville A, Fenelon G, Mahieux F (2004) Hallucinations in Parkinson’s disease: A follow-up study. Mov DisordGoogle Scholar
  24. 24.
    Dravid AR (1983) Deficits in cholinergic enzymes and muscarinic receptors in the hippocampus and striatum of senescent rats: effect of chronic hydergine treatment. Arch Int Pharmacodyn Ther 264(2):195–202PubMedGoogle Scholar
  25. 25.
    Fabbrini G, Barbanti P, Aurilia C, et al. (2002) Donepezil in the treatment of hallucinations and delusions in Parkinson’s disease. Neurol Sci 23(1):41–43PubMedGoogle Scholar
  26. 26.
    Fahn S, Elton RL (1987) Members of the UPDRS development Committee, Unified Parkinson’s disease rating scale, in Recent developments in Parkinson’s disease. Macmillan healthcare information, pp 153–163Google Scholar
  27. 27.
    Fenelon G, Mahieux F, Huon R, et al. (2000) Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain 123(Pt 4):733–745PubMedGoogle Scholar
  28. 28.
    Fenelon G, Thobois S, Bonnet AM, et al. (2002) Tactile hallucinations in Parkinson’s disease. J Neurol 249(12):1699–1703PubMedGoogle Scholar
  29. 29.
    Fergusson E, Howard R (2000) Donepezil for the treatment of psychosis in dementia with Lewy bodies. Int J Geriatr Psychiatry 15(3):280–281PubMedGoogle Scholar
  30. 30.
    Fernandez HH, Friedman JH, Jacques C, et al. (1999) Quetiapine for the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord 14(3):484–487PubMedGoogle Scholar
  31. 31.
    Fernandez HH, Lannon MC, Friedman JH, et al. (2000) Clozapine replacement by quetiapine for the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord 15(3):579–581PubMedGoogle Scholar
  32. 32.
    Fischer P, Danielczyk W, Simanyi M, et al. (1990) Dopaminergic psychosis in advanced Parkinson’s disease. Adv Neurol 53:391–397PubMedGoogle Scholar
  33. 33.
    Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMedGoogle Scholar
  34. 34.
    Forssman B, Kihlstrand S, Larsson LE (1972) Amantadine therapy in parkinsonism. Acta Neurol Scand 48(1):1–18PubMedGoogle Scholar
  35. 35.
    Freed CR, Greene PE, Breeze RE, et al. (2001) Transplantation of embryonic dopamine neurons for severe Parkinson’s disease. N Engl J Med 344(10):710–719PubMedGoogle Scholar
  36. 36.
    Frohna PA, Rothblat DS, Joyce JN, et al. (1995) Alterations in dopamine uptake sites and D1 and D2 receptors in cats symptomatic for and recovered from experimental parkinsonism. Synapse 19(1):46–55PubMedGoogle Scholar
  37. 37.
    Fuhrer R, Rouillon F (1989) La version franciaise de l’échelle CES-D (Center for Epidemiologic Studies–Depression scale). Description et traduction de l’échelle d’auto-évaluation. Psychiatrie Biol 4:163–166Google Scholar
  38. 38.
    Gagnon C, Bedard PJ, Di Paolo T (1990) Effect of chronic treatment of MPTP monkeys with dopamine D-1 and/or D-2 receptor agonists. Eur J Pharmacol 178(1):115–120PubMedGoogle Scholar
  39. 39.
    Giladi N, Treves TA, Paleacu D, et al. (2000) Risk factors for dementia, depression and psychosis in long-standing Parkinson’s disease. J Neural Transm 107(1):59–71PubMedGoogle Scholar
  40. 40.
    Girotti F, Soliveri P, Carella F, et al. (1988) Dementia and cognitive impairment in Parkinson’s disease. J Neurol Neurosurg Psychiatry 51(12):1498–1502PubMedGoogle Scholar
  41. 41.
    Gnanalingham KK, Smith LA, Hunter AJ, et al. (1993) Alterations in striatal and extrastriatal D-1 and D-2 dopamine receptors in the MPTP-treated common marmoset: an autoradiographic study. Synapse 14(2):184–194PubMedGoogle Scholar
  42. 42.
    Goetz CG (1999) Hallucinations in Parkinson’s disease: the clinical syndrome. Adv Neurol 80:419–423PubMedGoogle Scholar
  43. 43.
    Goetz CG, Burke PF, Leurgans S, et al. (2001) Genetic variation analysis in parkinson disease patients with and without hallucinations: case-control study. Arch Neurol 58(2):209–213PubMedGoogle Scholar
  44. 44.
    Goetz CG, Leurgans S, Pappert EJ, et al. (2001) Prospective longitudinal assessment of hallucinations in Parkinson’s disease. Neurology 57(11):2078–2082PubMedGoogle Scholar
  45. 45.
    Goetz CG, Pappert EJ, Blasucci LM, et al. (1998) Intravenous levodopa in hallucinating Parkinson’s disease patients: high-dose challenge does not precipitate hallucinations. Neurology 50(2):515–517PubMedGoogle Scholar
  46. 46.
    Goetz CG, Stebbins GT (1995) Mortality and hallucinations in nursing home patients with advanced Parkinson’s disease. Neurology 45(4):669–671PubMedGoogle Scholar
  47. 47.
    Goetz CG, Stebbins GT (1993) Risk factors for nursing home placement in advanced Parkinson’s disease. Neurology 43(11):2227–2229PubMedGoogle Scholar
  48. 48.
    Goetz CG, Tanner CM, Klawans HL (1982) Pharmacology of hallucinations induced by long-term drug therapy. Am J Psychiatry 139(4):494–497PubMedGoogle Scholar
  49. 49.
    Goetz CG, Vogel C, Tanner CM, et al. (1998) Early dopaminergic drug-induced hallucinations in parkinsonian patients. Neurology 51(3):811–814PubMedGoogle Scholar
  50. 50.
    Graham JM, Grunewald RA, Sagar HJ (1997) Hallucinosis in idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 63(4):434–440PubMedGoogle Scholar
  51. 51.
    Graham WC, Clarke CE, Boyce S, et al. (1990) Autoradiographic studies in animal models of hemi-parkinsonism reveal dopamine D2 but not D1 receptor supersensitivity. II.Unilateral intra-carotid infusion of MPTP in the monkey (Macaca fascicularis). Brain Res 514(1):103–110PubMedGoogle Scholar
  52. 52.
    Greene P, Cote L, Fahn S (1993) Treatment of drug-induced psychosis in Parkinson’s disease with clozapine. Adv Neurol 60:703–706PubMedGoogle Scholar
  53. 53.
    Haeske-Dewick HC (1995) Hallucinations in Parkinson’s disease: characteristics and associated clinical features. Int J Geriatr Psychiatry 10:487–495Google Scholar
  54. 54.
    Herzog J, Volkmann J, Krack P, et al. (2003) Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord 18(11):1332–1337PubMedGoogle Scholar
  55. 55.
    Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17(5):427–442PubMedGoogle Scholar
  56. 56.
    Holroyd S, Currie L, Wooten GF (2001) Prospective study of hallucinations and delusions in Parkinson’s disease. J Neurol Neurosurg Psychiatry 70(6):734–738PubMedGoogle Scholar
  57. 57.
    Hornykiewicz O, Kish SJ (1987) Biochemical pathophysiology of Parkinson’s disease. Adv Neurol 45:19–34PubMedGoogle Scholar
  58. 58.
    Inzelberg R, Kipervasser S, Korczyn AD (1998) Auditory hallucinations in Parkinson’s disease. J Neurol Neurosurg Psychiatry 64(4):533–535PubMedGoogle Scholar
  59. 59.
    Inzelberg R, Ramirez A, Nisipeanu P, et al. (2004) Familial risk factors for hallucinations in Parkinson’s disease. Mov Disord 19(Suppl 9):S401Google Scholar
  60. 60.
    Jellinger K (1987) The pathology of parkinsonism. In: Marsden CD, Fahn S (eds) Movement Disorders, vol 2. Butterworth: London, pp 124–165Google Scholar
  61. 61.
    Jimenez-Jimenez FJ, Orti-Pareja M, Gasalla T, et al. (1997) Cenesthetic hallucinations in a patient with Parkinson’s disease. J Neurol Neurosurg Psychiatry 63(1):120Google Scholar
  62. 62.
    Jurko MF, Andy OJ (1961) Electrical and behavioral changes following thalamotomy. Surg Forum 12:404–406PubMedGoogle Scholar
  63. 63.
    Korczyn AD, Brooks DJ, Brunt ER, et al. (1998) Ropinirole versus bromocriptine in the treatment of early Parkinson’s disease: a 6-month interim report of a 3-year study. 053 Study Group. Mov Disord 13(1):46–51Google Scholar
  64. 64.
    Korczyn AD, Brunt ER, Larsen JP, et al. (1999) A 3-year randomized trial of ropinirole and bromocriptine in early Parkinson’s disease. The 053 Study Group. Neurology 53(2):364–370PubMedGoogle Scholar
  65. 65.
    Kurita A, Ochiai Y, Kono Y, et al. (2003) The beneficial effect of donepezil on visual hallucinations in three patients with Parkinson’s disease. J Geriatr Psychiatry Neurol 16(3):184–188PubMedGoogle Scholar
  66. 66.
    Lees AJ, Smith E (1983) Cognitive deficits in the early stages of Parkinson’s disease. Brain 106(Pt 2):257–270PubMedGoogle Scholar
  67. 67.
    Lewy FH (1923) Die Lehre vom Tonus und die der Bewegung, ed. S Verlag, BerlinGoogle Scholar
  68. 68.
    Lieberman A (1998) Managing the neuropsychiatric symptoms of Parkinson’s disease. Neurology 50(6 Suppl 6): S33–S38; discussion S44–S48PubMedGoogle Scholar
  69. 69.
    Litvan I, MacIntyre A, Goetz CG, et al. (1998) Accuracy of the clinical diagnoses of Lewy body disease, Parkinson disease, and dementia with Lewy bodies: a clinicopathologic study. Arch Neurol 55(7):969–978PubMedGoogle Scholar
  70. 70.
    Mahieux F, Fenelon G, Flahault A, et al. (1998) Neuropsychological prediction of dementia in Parkinson’s disease. J Neurol Neurosurg Psychiatry 64(2):178–183PubMedGoogle Scholar
  71. 71.
    Makoff AJ, Graham JM, Arranz MJ, et al. (2000) Association study of dopamine receptor gene polymorphisms with drug-induced hallucinations in patients with idiopathic Parkinson’s disease. Pharmacogenetics 10(1):43–48PubMedGoogle Scholar
  72. 72.
    McKeith I, Del Ser T, Spano P, et al. (2000) Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet 356(9247):2031–2036CrossRefPubMedGoogle Scholar
  73. 73.
    McKeith I, Mintzer J, Aarsland D, et al. (2004) Dementia with Lewy bodies. Lancet Neurol 3(1):19–28PubMedGoogle Scholar
  74. 74.
    McKeith IG, Fairbairn AF, Bothwell RA, et al. (1994) An evaluation of the predictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology 44(5):872–877PubMedGoogle Scholar
  75. 75.
    McKeith IG, Galasko D, Kosaka K, et al. (1996) Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 47(5):1113–1124PubMedGoogle Scholar
  76. 76.
    Melamed E, Zoldan J, Freidberg G (1993) Is hallucinosis in Parkinson’s disease due to central serotonergic hyperactivity? Mov Disord 8:406–407Google Scholar
  77. 77.
    Merims D, Shabtai H, Korczyn AD, et al. (2004) Antiparkinsonian medication is not a risk factor for the development of hallucinations in Parkinson’s disease. J Neural Transm 111 (10–11):1447–1453PubMedGoogle Scholar
  78. 78.
    Mojnes H (1949) Paralysis agitans. A clinical and genetic study. Acta Psychiatr Scand, p S54Google Scholar
  79. 79.
    Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389PubMedGoogle Scholar
  80. 80.
    Morris SK, Olichney JM, Corey-Bloom J (1998) Psychosis in Dementia With Lewy Bodies. Semin Clin Neuropsychiatry 3(1):51–60PubMedGoogle Scholar
  81. 81.
    Moskovitz C, Moses H 3rd, Klawans HL (1978) Levodopa-induced psychosis: a kindling phenomenon. Am J Psychiatry 135(6):669–675PubMedGoogle Scholar
  82. 82.
    Naimark D, Jackson E, Rockwell E, et al. (1996) Psychotic symptoms in Parkinson’s disease patients with dementia. J Am Geriatr Soc 44(3):296–299PubMedGoogle Scholar
  83. 83.
    Nausieda PA, Weiner WJ, Kaplan LR, et al. (1982) Sleep disruption in the course of chronic levodopa therapy: an early feature of the levodopa psychosis. Clin Neuropharmacol 5(2):183–194PubMedGoogle Scholar
  84. 84.
    Oertel WH (2000) Pergolide versus L-dopa (PELMOPET). Mov Disord 15 (Suppl 3):S4Google Scholar
  85. 85.
    Olanow CW, Freeman T, Kordower J (2001) Transplantation of embryonic dopamine neurons for severe Parkinson’s disease. N Engl J Med 345(2):146; author reply 147Google Scholar
  86. 86.
    Onofrj M, Thomas A, Iacono D, et al. (2001) Switch-over from tolcapone to entacapone in severe Parkinson’s disease patients. Eur Neurol 46(1):11–16Google Scholar
  87. 87.
    Papapetropoulos S, Gonzalez J, Lieberman A, et al. (2004) Dementia in Parkinson disease. Prevalence and clinical correlates from a population of brain donors. Mov Disord 19:S192Google Scholar
  88. 88.
    Pappert EJ, Goetz CG, Niederman FG, et al. (1999) Hallucinations, sleep fragmentation, and altered dream phenomena in Parkinson’s disease. Mov Disord 14(1):117–121PubMedGoogle Scholar
  89. 89.
    Parkes JD, Baxter RC, Marsden CD, et al. (1974) Comparative trial of benzhexol, amantadine, and levodopa in the treatment of Parkinson’s disease. J Neurol Neurosurg Psychiatry 37(4):422–426PubMedGoogle Scholar
  90. 90.
    Parkinson Study Group (1997) Entacapone improves motor fluctuations in levodopa-treated Parkinson’s disease patients. Parkinson Study Group. Ann Neurol 42(5):747–755PubMedGoogle Scholar
  91. 91.
    Parkinson Study Group (2000) Pramipexole vs levodopa as initial treatment for Parkinson disease: a randomized controlled trial. Parkinson Study Group. JAMA 284(15):1931–1938PubMedGoogle Scholar
  92. 92.
    Perry EK, Kerwin J, Perry RH, et al. (1990) Cerebral cholinergic activity is related to the incidence of visual hallucinations in senile dementia of the Lewy body type. Dementia 1:2–4Google Scholar
  93. 93.
    Perry EK, Kerwin J, Perry RH, et al. (1990) Visual hallucinations and the cholinergic system in dementia. J Neurol Neurosurg Psychiatry 53(1):88Google Scholar
  94. 94.
    Perry EK, Marshall E, Kerwin J, et al. (1990) Evidence of a monoaminergic-cholinergic imbalance related to visual hallucinations in Lewy body dementia. J Neurochem 55(4):1454–1456PubMedGoogle Scholar
  95. 95.
    Perry EK, McKeith I, Thompson P, et al. (1991) Topography, extent, and clinical relevance of neurochemical deficits in dementia of Lewy body type, Parkinson’s disease, and Alzheimer’s disease. Ann N Y Acad Sci 640:197–202PubMedGoogle Scholar
  96. 96.
    Piggott MA, Marshall EF, Thomas N, et al. (1999) Striatal dopaminergic markers in dementia with Lewy bodies, Alzheimer’s and Parkinson’s diseases: rostrocaudal distribution. Brain 122(Pt 8)1449–1468PubMedGoogle Scholar
  97. 97.
    Poewe W, Hogl B (2000) Parkinson’s disease and sleep. Curr Opin Neurol 13(4):423–426PubMedGoogle Scholar
  98. 98.
    Poewe WH, Deuschl G, Gordin A, et al. (2002) Efficacy and safety of entacapone in Parkinson’s disease patients with suboptimal levodopa response: a 6-month randomized placebo-controlled double-blind study in Germany and Austria (Celomen study). Acta Neurol Scand 105(4):245–255PubMedGoogle Scholar
  99. 99.
    Pope-Coleman A, Tinker JP, Schneider JS (2000) Effects of GM1 ganglioside treatment on pre- and postsynaptic dopaminergic markers in the striatum of parkinsonian monkeys. Synapse 36(2):120–128PubMedGoogle Scholar
  100. 100.
    Przedborski S, Jackson-Lewis V, Popilskis S, et al. (1991) Unilateral MPTP-induced parkinsonism in monkeys. A quantitative autoradiographic study of dopamine D1 and D2 receptors and re-uptake sites. Neurochirurgie 37(6):377–382PubMedGoogle Scholar
  101. 101.
    Rabey JM, Treves TA, Neufeld MY, et al. (1995) Low-dose clozapine in the treatment of levodopa-induced mental disturbances in Parkinson’s disease. Neurology 45(3 Pt 1):432–434PubMedGoogle Scholar
  102. 102.
    Raisman R, Cash R, Ruberg M, et al. (1985) Binding of [3H]SCH 23390 to D-1 receptors in the putamen of control and parkinsonian subjects. Eur J Pharmacol 113(3):467–468PubMedGoogle Scholar
  103. 103.
    Rascol O, Brooks DJ, Korczyn AD, et al. (2000) A five-year study of the incidence of dyskinesia in patients with early Parkinson’s disease who were treated with ropinirole or levodopa. 056 Study Group. N Engl J Med 342(20):1484–1491PubMedGoogle Scholar
  104. 104.
    Reading PJ, Luce AK, McKeith IG (2001) Rivastigmine in the treatment of parkinsonian psychosis and cognitive impairment: preliminary findings from an open trial. Mov Disord 16(6):1171–1174PubMedGoogle Scholar
  105. 105.
    Richard IH, Papka M, Rubio A, et al. (2002) Parkinson’s disease and dementia with Lewy bodies: one disease or two? Mov Disord 17(6):1161–1165PubMedGoogle Scholar
  106. 106.
    Rinne JO, Laihinen A, Rinne UK, et al. (1993) PET study on striatal dopamine D2 receptor changes during the progression of early Parkinson’s disease. Mov Disord 8(2):134–138PubMedGoogle Scholar
  107. 107.
    Rinne JO, Laihinen A, Ruottinen H, et al. (1995) Increased density of dopamine D2 receptors in the putamen, but not in the caudate nucleus in early Parkinson’s disease: a PET study with [11C]raclopride. J Neurol Sci 132(2):156–161PubMedGoogle Scholar
  108. 108.
    Rinne JO, Rinne JK, Laakso K, et al. (1985) Dopamine D-1 receptors in the parkinsonian brain. Brain Res 359(1–2):306–310PubMedGoogle Scholar
  109. 109.
    Rinne UK, Bracco F, Chouza C, et al. (1998) Early treatment of Parkinson’s disease with cabergoline delays the onset of motor complications. Results of a double-blind levodopa controlled trial. The PKDS009 Study Group. Drugs 55(Suppl 1):S23–S30Google Scholar
  110. 110.
    Rinne UK, Larsen JP, Siden A, et al. (1998) Entacapone enhances the response to levodopa in parkinsonian patients with motor fluctuations. Nomecomt Study Group. Neurology 51(5):1309–1314PubMedGoogle Scholar
  111. 111.
    Rioux L, Frohna PA, Joyce JN, et al. (1997) The effects of chronic levodopa treatment on pre- and postsynaptic markers of dopaminergic function in striatum of parkinsonian monkeys. Mov Disord 12(2):148–158PubMedGoogle Scholar
  112. 112.
    Robinson TE, Kolb B (1997) Persistent structural modifications in nucleus accumbens and prefrontal cortex neurons produced by previous experience with amphetamine. J Neurosci 17(21):8491–8497PubMedGoogle Scholar
  113. 113.
    Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for Alzheimer’s disease. Am J Psychiatry 141(11):1356–1364PubMedGoogle Scholar
  114. 114.
    Sanchez-Ramos JR, Ortoll R, Paulson GW (1996) Visual hallucinations associated with Parkinson disease. Arch Neurol 53(12):1265–1268PubMedGoogle Scholar
  115. 115.
    Schenck CH, Bundlie SR, Mahowald MW (1996) Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder. Neurology 46(2):388–393PubMedGoogle Scholar
  116. 116.
    Schwab RS, Fabing HD, Prichard JS (1950) Psychiatric symptoms and syndromes in Parkinson’s disease. Am J Psychiatry 107:901–907Google Scholar
  117. 117.
    Singer C, Uzcategui G, Lyons K, et al. (2002) Efficacy and tolerability of amantadine: a retrospective review of old and new indications at a tertiary referral center. Mov Disord 17(S5):279Google Scholar
  118. 118.
    Steckler T, Sahgal A (1995) The role of serotonergic-cholinergic interactions in the mediation of cognitive behaviour. Behav Brain Res 67(2):165–199PubMedGoogle Scholar
  119. 119.
    Svensson TH, Mathe JM, Andersson JL, et al. (1995) Mode of action of atypical neuroleptics in relation to the phencyclidine model of schizophrenia: role of 5-HT2 receptor and alpha 1-adrenoceptor antagonism (corrected). J Clin Psychopharmacol 15(1 Suppl 1):S11–S18Google Scholar
  120. 120.
    Sweet RD, McDowell FH, Feigenson JS, et al. (1976) Mental symptoms in Parkinson’s disease during chronic treatment with levodopa. Neurology 26(4):305–310PubMedGoogle Scholar
  121. 121.
    Tanner CM, Vogel C, Goetz CG (1983) Hallucinations in Parkinson’s disease: a population study. Ann Neurol 14:136Google Scholar
  122. 122.
    Wang J, Zhao C, Chen B, et al. (2004) Polymorphisms of dopamine receptor and transporter genes and hallucinations in Parkinson’s disease. Neurosci Lett 355(3):193–196PubMedGoogle Scholar
  123. 123.
    Wechsler D (1981) Wechsler Adult Intelligence Scale-Revised Manual, ed. P Corporation, ClevelandGoogle Scholar
  124. 124.
    Whitehouse PJ, Hedreen JC, White CL 3rd, et al. (1983) Basal forebrain neurons in the dementia of Parkinson disease. Ann Neurol 13(3):243–248PubMedGoogle Scholar
  125. 125.
    Wolters EC (1999) Dopaminomimetic psychosis in Parkinson’s disease patients: diagnosis and treatment. Neurology 52(7 Suppl 3):S10–S13PubMedGoogle Scholar
  126. 126.
    Wolters EC (2001) Intrinsic and extrinsic psychosis in Parkinson’s disease. J Neurol 248(Suppl 3):S22–S27Google Scholar
  127. 127.
    Zoldan J, Friedberg G, Goldberg-Stern H, et al. (1993) Ondansetron for hallucinosis in advanced Parkinson’s disease. Lancet 341(8844):562–563Google Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  1. 1.Department of NeurologyUniversity of Miami, School of Medicine, Room 4004Miami (FL)USA

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