While Parkinson’s disease is best known for the stiffness, tremors and difficulty with balance and walking it causes, 40% of people with the disease are also affected by hallucinations and delusions. These symptoms are known as psychosis associated with Parkinson’s disease, and while they may be the result of brain changes caused by the disease, other factors may contribute to their onset.
Hallucinations occur when the person is awake and can affect any of the five senses. The person may see or hear things that are not there, or they may experience phantom smells, unusual tastes, or feel things touching their skin. However, hallucinations involving smell, taste, and sensation are less common than visual or auditory experiences.
Delusions occur less frequently, affecting only about 8% of people with Parkinson’s disease, but are found more often in people with advanced disease. Delusions include thoughts, feelings, or fears that have no physical basis and are not part of that individual’s personality.
The most common delusions in people with Parkinson’s disease are unfounded jealousy, feelings of persecution, health problems and paranoia. These delusions can lead to agitation and aggression in patients with Parkinson’s disease and may cause them to act physically or refuse necessary medications that they mistakenly believe are poisonous.
Medications are one of the three main factors that can lead to the onset of psychosis in people with Parkinson’s disease. Many drugs prescribed to treat motor function disorders can also cause temporary changes in mood and behavior, due to their effect on the balance of dopamine in the brain.
Another factor that can contribute to psychosis in people with the disease is Parkinson’s dementia. Dementia can be diagnosed in people who have been living with Parkinson’s disease for a year and whose reasoning skills have diminished. As Parkinson’s disease progresses, changes in the brain that first affect muscle control and coordination then spread to parts of the brain that control cognitive function, which can lead to hallucinations.
The third major contributor to hallucinations and delusions in patients with Parkinson’s disease is delirium, which can lead to sudden but transient changes in behavior. Delirium may not take long to set in, but it can usually be corrected by addressing the causes that led to the illness in the first place. These can include fevers, infections, trauma, stroke, heart or liver disease, and medications, to name a few. Delirium in people with Parkinson’s disease can also be induced by changes in the environment, such as a hospital stay.
Other factors contributing to psychosis associated with Parkinson’s disease include sleep problems, vision problems, age, and alcohol consumption. It is estimated that half of people living with Parkinson’s disease suffer from depression, which can also increase the risk of psychosis.
It is important that Parkinson’s psychosis be reported immediately to the person’s doctor or medical provider to prevent the condition from getting worse. Medication changes may be made to lessen symptoms of psychosis caused by drugs used to treat Parkinson’s disease, and in other cases, antipsychotics may be prescribed to adjust brain chemistry leading to hallucinations. However, in some cases, antipsychotics can cause increased hallucinations, so they should be used with caution.
Information provided by Visiting Angels, America’s Choice for Home Care. Visiting Angels’ non-medical home care services allow people to continue to enjoy independence from their daily routines and familiar surroundings. To book an appointment for a no-obligation home consultation, call 330-332-1203.