What Caregivers Should Know About Parkinson’s Disease Psychosis
An unsteady walk, freezing limb and shaky hands are symptoms that are synonymous with Parkinson’s disease. This disease is devastating and interferes with movement. As Parkinson’s disease progresses, it produces a range of other issues. Also, this neurological condition includes the symptom called Parkinson’s disease psychosis.
Parkinson’s disease psychosis is a disabling non-motor feature of Parkinson’s and can be experienced by people who have the disease. In fact, experts say that half of those have Parkinson’s can experience psychosis, often through visual hallucination.
Causes and Symptoms of Psychosis in Patients with Parkinson’s Disease
Researchers have not known the exact cause of the occurrence of psychosis. However, there are risk factors that can play a role such as the patient’s age, the length of time he has been suffering Parkinson’s, whether he is currently taking medications which increase the brain’s dopamine levels and the severity of other symptoms. A lot of the prescriptions used for treating Parkinson’s motor symptoms increase the amount of dopamine in the brain. But, elevated levels of dopamine can set off psychosis episodes.
Typically, a psychotic episode includes seeing objects and people who aren’t really there, delusions and hearing noises which do not exist. Often, the delusions of a patient take the form of paranoid thoughts like believing his spouse is cheating on him or a friend or relative has poisoned his food.
In the later stages, such psychotic incidents can cause the patient to experience more confusion or impaired reality like an inability to distinguish what he experiences personally from what’s really going on in the outside world. This typically develops seven years following a diagnosis. However, it is important to note that there are other similar conditions which can cause a misdiagnosis.
Treating Parkinson’s Disease Psychosis
It is really challenging to treat psychosis. There are no FDA-approved treatment options to manage this condition and only a few of those who have this tell their doctor of their symptoms.
- Determining the cause. A doctor will first identify whether there‘s an underlying illness which could be causing the patient to have psychotic symptoms. To decrease psychotic episodes, the focus is on the underlying cause. If there is no identifiable outside source of Parkinson’s disease psychosis, physicians usually consider the medications the patient is taking. Decreasing the dosage of medications meant to enhance dopamine may minimize psychosis; however, the trade-off is the motor symptoms of the patient may worsen at a faster rate.
- Using atypical antipsychotics. These include clozapine and quetiapine. However, such drugs are also likely to make motor symptoms worse. Pimavanserin is a newer drug developed for psychosis in patients with Parkinson’s disease. This works by targeting serotonin receptors and is likely to alleviate such incidents without impacting the motor performance of the patient.
Some of the obvious triggers of Parkinson’s disease psychosis include metabolic or electrolyte imbalances, sleep deprivation, infections and medications. Overall susceptibility is associated with the mental status of the sufferer. Such episodes may appear at night when there is not much background stimulation or if the patient is in a quiet room by himself.
Also, medications are a culprit as lot of prescribed drugs for Parkinson’s increase dopamine levels in the brain. Parkinson’s disease includes a loss or malfunction of neurons which produce dopamine, a brain neurotransmitter that relays messages to the brain which control coordination and movement.
The Role of Caregivers
People who offer care for patients with Parkinson’s disease and other neurological conditions which cause delusions and hallucinations take part in different behavioral interventions in order to keep the patient in control and calm during a psychotic episode. It is imperative to maintain an honest relationship with a loved one with Parkinson’s. Affinity Caretaker, Inc., a leading provider of non-medical home care in Seven Mile Road Livonia MI, suggest that caregivers ask about abnormal experiences and ideas. Often, members of the family are surprised to know that their loved one encounter such incidences as they do not divulge this information unless asked.
Additionally, family members must observe signs of impulse control disorders like abnormal sexual interests, excessive gambling and excess spending behaviors. In general, such behaviors are not detected unless caregivers know what to look for or the physician starts asking specific questions.