Journal Article

Management of psychiatric and cognitive complications in Parkinson’s disease

Goldman, Jennifer, Aarsland, Dag, Dobkin, Roseanne, Biundo, Roberta, Weintraub, Daniel, Lewis, Simon

2022

Overview

AbstractNeuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson’s disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD
• Subject: Affective disorders / Alzheimer's disease / Anxiety / Apathy / Clinical Review / Cognition / Cognition & reasoning / Cognitive ability / Cognitive Dysfunction - etiology / Cognitive Dysfunction - therapy / Dementia / Dopamine receptors / Drug therapy / Electroconvulsive therapy / Epidemiology / Humans / Mental disorders / Mood Disorders / Movement disorders / Neurodegenerative diseases / Neurosciences / Parkinson Disease - drug therapy / Parkinson Disease - therapy / Parkinson's disease / Psychopharmacology / Psychosis / Psychotherapy / Psychotic Disorders - epidemiology / Risk factors