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Neuropsychiatric Adverse Effects of Antiparkinsonian Drugs

Characteristics, Evaluation and Treatment

  • Review Article
  • Adverse Effects
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Summary

Parkinson’s disease (PD) is a progressive neurological condition that causes considerable disability in the elderly. Drugs used to treat PD, such as levodopa, offer symptomatic relief but often have neuropsychiatric adverse effects, most prominently psychosis and delirium. Aged patients and those with dementia are particularly vulnerable to these adverse effects. Evaluating PD patients with drug-induced neuropsychiatric adverse effects is made difficult by their complex clinical presentations.

The treatment of drug-induced psychosis and delirium begins with manipulating the antiparkinsonian drug regimen, but this frequently worsens motor function. Atypical antipsychotics such as clozapine have been successfully employed to treat the psychosis without worsening the motor disability. Patient intolerance of clozapine therapy has prompted open-label studies with newer agents such as risperidone, remoxipride, zotepine, mianserin and ondansetron.

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Authors and Affiliations

  1. Mental Health Division, Portland Veterans Affairs Medical Center, and Department of Psychiatry, Oregon Health Sciences University, Portland, Oregon, USA

    B. Kay Young &  Linda Ganzini

  2. Department of Neurology, Oregon Health Sciences University, Portland, Oregon, USA

    Richard Camicioli

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  1. B. Kay Young
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  2. Richard Camicioli
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  3. Linda Ganzini
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Correspondence to Linda Ganzini.

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Young, B.K., Camicioli, R. & Ganzini, L. Neuropsychiatric Adverse Effects of Antiparkinsonian Drugs. Drugs & Aging 10, 367–383 (1997). https://doi.org/10.2165/00002512-199710050-00005

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