Expert Briefings: Parkinson's Disease Psychosis: Hallucinations, Delusions and Paranoia

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Christopher G. Goetz, M.D., Professor of Neurological Sciences, Professor of Pharmacology at Rush University Medical Center a Parkinson's Foundation Center of Excellence

As part of chronic Parkinson's disease and its treatment, psychotic behaviors occur in over 50% of patients.  These problems include illusions (perceptual errors), hallucinations (false perceptions), delusional thinking and even suspiciousness and paranoid behaviors.  In most instances, hallucinations are visual, but they can involve the auditory, tactile, olfactory, and gustatory (taste) systems as well.  Because such experiences tend to be repetitive (the same little black dog runs across the room), the patient often has insight and recognizes the hallucination as a false perception.  However, the situation can become more problematic with rigid insistence that the images are real and even threatening.  Psychotic behaviors are a high risk for nursing home placement, because families find them difficult to manage, especially if agitation and paranoid accusations are lodged against the caregiver.  Even though hallucinations usually start out as minimal intrusions, the spectrum of psychotic behaviors is progressive, and early recognition by patient, family and physician allows for detection and treatment interventions.  Life style changes, medication adjustments, and new specifically anti-psychotic treatments are available. 

At the end of this presentation, participants will:

  • Understand the types of problems experienced by patients who develop the syndrome of Parkinson's Disease Psychosis
  • Recognize the burdens and impact on quality of life to both patients and caregivers when Parkinson's Disease Psychosis develops
  • List current treatments and strategies for mitigating and eliminating Parkinson's Disease Psychosis.


  • Understand the importance of exercise and activity for living well with PD
  • Recognize current evidence and gaps in knowledge concerning exercise and activity benefits
  • Appreciate evidence suggesting vigorous activity might have neuroprotective benefits 

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