Hallucinations and delusions: Surprisingly common occurrence in Parkinson’s disease
(BPT) – For the approximately one million Americans living with Parkinson’s disease, the visible motor (movement-related) symptoms associated with the condition are all too familiar. These include tremors, stiff muscles, limited movement and problems standing. However, there is a common non-motor aspect of advanced Parkinson’s disease that isn’t as widely understood or recognized by patients, caregivers, or doctors.
Common symptoms of this condition include hallucinations and delusions. Hallucinations are when a person sees or hears things that are not real. For example, a common hallucination is seeing a person or animal in the room that does not actually exist. Delusions are false and irrational beliefs, and in this case, often involve suspicions of spousal infidelity or other paranoid themes.
The condition is known among the medical community as Parkinson’s disease psychosis, or ‘PDP.’ You may be surprised to learn that PDP affects more than half of all Parkinson’s patients at some point over the course of their disease. Current scientific research indicates that the hallucinations and delusions associated with PDP can result from the progression of the underlying Parkinson’s disease itself.
Understandably, the appearance of hallucinations or delusions can have a negative impact on quality of life for those living with Parkinson’s disease. PDP is also associated with increased distress and burden for caregivers, which can lead to nursing home placement. An especially unfortunate reality of PDP is that many Parkinson’s patients feel embarrassed to report symptoms to their doctors because of the stigma associated with mental disorders. In fact, a surprisingly small amount, only 10-20 percent, report their symptoms spontaneously.
‘We are finding that with advancing Parkinson’s disease, complex challenges such as PDP often arise,’ said Dr. Michael S. Okun, National Medical Director of the National Parkinson Foundation. ‘In the case of PDP, the strain on the caregiver can be substantial. As such, it is important to report any symptoms when they start, with a goal of effectively managing the condition and avoiding unnecessary nursing home placement.’
Interestingly, cases that are correctly diagnosed may not be simple to treat. Parkinson’s medications may exacerbate PDP symptoms. Often doctors adjust Parkinson’s medications to treat the psychosis, but in doing so, there is the potential to further compromise the patient’s motor skills. Given the treatment challenges, it is important that patients, their caregivers, and doctors regularly speak about potential symptoms. Open communication may help lead to an earlier diagnosis and an appropriate treatment plan.
To properly understand PDP, the first step is to recognize that it is a commonly associated aspect of Parkinson’s disease and not something to be ashamed or embarrassed about. Obtaining information is essential and people experiencing PDP and their caregivers are not without options.
CareMAP is an online resource created by the National Parkinson Foundation (NPF) that offers families the resources and support they need to provide the best care for advanced stage Parkinson’s disease. The site offers videos, articles, community resources and guides. Visit CareMAP at caremap.parkinson.org to learn more or call the NPF Helpline at 1-800-4PD-INFO (473-4636). The Helpline specialists can answer questions in English and Spanish.