Psychological Symptoms of Parkinson's: Hallucinations and Delusions

While the physical symptoms of Parkinson's disease, such as muscle rigidity and tremors, are well known, around half of affected individuals are facing lesser-known psychological symptoms. These symptoms include hallucinations and delusions. In this article, we will outline these overlooked symptoms and offer guidance on dealing with them to maintain a good quality of life.

Symptoms of Parkinson's Hallucinations and Delusions

Parkinson’s Disease can lead to hallucinations and delusions, where your parent might:

• See, hear, feel, or smell things that aren’t present – hallucinations
• Hold strong beliefs that aren't based on reality – delusions

Initially, these symptoms may appear harmless and easily dismissable, like hearing a non-existent noise. However, as the disease progresses, these symptoms can become more severe, leading to serious clinical behaviors such as:

• Paranoia
• Publicly stating false beliefs that they are experiencing
• Thoughts or actions showing a disconnect from reality (belief of superpowers, …)

As these symptoms intensify, distinguishing reality from delusion becomes challenging for the patient. That is why caregivers need to take action as soon as possible after these symptoms begin to manifest.

Addressing Hallucinations and Delusions in Parkinson's

Managing hallucinations and delusions in Parkinson's is not simple and straightforward, as it includes a team of several medical professionals. The key steps in recognizing hallucinations and delusions in the patient include:

1. Medical Assessment: Seek advice from a Parkinson's specialist to evaluate the severity of the disease and rule out other potential causes of hallucinations and delusions like dementia. The specialist can also determine if current medications might be contributing to these symptoms, as some can induce hallucinations due to sudden dopamine surges within the brain.
2. Medication Review: If the hallucinations and delusions are considered infrequent or benign, treatment may be delayed in order to allow medications for motor issues to be adjusted and continued. The Parkinson's Foundation emphasizes that medication can be a balancing act, reducing these psychological symptoms without aggravating motor symptoms.
3. Antipsychotic Medications: In some cases, antipsychotic medications may be prescribed to address the chemical imbalances within the brain. These don't interfere with Parkinson's motor medications.

The American Parkinson Disease Association (APDA) highlights that hallucinations can arise from sudden brain changes that are not related to dopamine-enhancing medication, but are caused by the progression of Parkinson's disease. While it's challenging to predict who might develop these psychological symptoms, certain factors, such as age, disease severity, duration of the disease, and dopamine-based treatments, can increase the risk.

Detecting early symptoms of hallucinations and delusions can be tricky, but crucial. Encouraging those with Parkinson's to speak out at the first signs of hallucinations and delusions is vital – the sooner a symptom is addressed, the better the outcome.

Credits:
Hallucinations and delusions - as a side effect
Delusion/Hallucinations 
Mental health concerns in advanced PD – psychosis and behavioral problems