Parkinson disease psychosis

Hallucinations and delusions in patients with Parkinson disease, developing in 25–40% as the disease progresses. Often triggered by dopaminergic medication.

ICD-10 F06.01 drug

Also known as: Hallucinations in Parkinson disease

Drugs used for this condition

BPimavanserinFirst line · Atypical antipsychotic, selective 5-HT2A inverse agonistFDA-approved for Parkinson disease psychosis (hallucinations and delusions). Advantage over typical antipsychotics – no D2 blockade, so motor symptoms are not worsened. AAN 2023 recommends pimavanserin as first-line pharmacotherapy after dopaminergic therapy adjustment and management of contributing factors (infections, sleep, delirium).

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit