Treat Bothersome Parkinson's Disease Hallucinations

If you have hallucinations and psychosis in the setting of Parkinson’s disease and it is bothersome to you or to your family members here are a few useful tips:

• Check for a urinary tract infection
• Make sure there is no pneumonia or other infection
• Medications may be the cause especially pain medications, muscle relaxants, and benzodiazepines 
• Temporary reduction in Parkinson’s treatment medication dosages may help but may also worsen Parkinson symptoms
• In some cases stopping anticholinergics (trihexyphenidyl, artane, beztropine, benadryl), amantadine, MAO-B inhibitors (selegiline, rasagiline, zelapar, others), entacapone, and even dopamine agonists may be helpful
• Small doses of sinemet or madopar can beused to try to gain control of the hallucinations/psychosis, as small doses may be less likely to result in hallucinations
• Dopamine blocking medications such as seroquel (Quetiapine) or clozaril (Clozapine) are the best medications in Parkinson's disease
• Other dopamine blockers such as haldol, resperidal, and olanzapine may worsen Parkinson’s symptoms and are rarely used
• It is important to see the doctor immediately for treatment of hallucinations
• In some cases the hallucinations are not bothersome and will not require treatment