Hallucinations and parkinson's disease in the elderly: pitfalls and medical care

Arnaud Leroy 1, 2 Jean Roche Kathy Dujardin 3 Didier Duthoit Francois Puisieux 4 Delphine Pins 1 Renaud Jardri 1 Eric Boulanger 5
1 SCALab - Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193
2 JPArc - U837 Inserm - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer
3 DN2M - Troubles cognitifs dégénératifs et vasculaires
4 CERIM - Santé publique : épidémiologie et qualité des soins-EA 2694
5 LIRIC - Lille Inflammation Research International Center
Abstract : Hallucinations are common neuropsychiatric symptoms in Parkinson's disease (PD), with a significant prognosis impact. It is necessary to rule out other diagnoses that can be mentioned when hallucinations occur in old patients with PD. The various etiological factors must be systematically checked and can help for diagnosis. Medical care will be focused on treating the primary cause (medical or iatrogenic origin) and will privilege non-pharmacological strategies. Due to their frequent adverse effects, antipsychotic medication should be limited and started at low dose in old patients with multiple comorbidities. Clozapine and quetiapine have the highest level of recommendation in this indication. In the future, defining fMRI-based targets for noninvasive brain stimulation tools should pave the way for innovative non-pharmacological treatment of hallucinations.
Keywords : Mesh:Humans Mesh:Hallucinations/etiology* Mesh:Parkinson Disease/complications* Mesh:Practice Guidelines as Topic Mesh:Algorithms Mesh:Hallucinations/diagnosis Mesh:Hallucinations/therapy*
Type de document :
Article dans une revue
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https://hal.univ-lille.fr/hal-02474403
Contributeur : Lilloa Université de Lille <>
Soumis le : mardi 11 février 2020 - 12:52:11
Dernière modification le : mercredi 12 février 2020 - 01:46:13

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Arnaud Leroy, Jean Roche, Kathy Dujardin, Didier Duthoit, Francois Puisieux, et al.. Hallucinations and parkinson's disease in the elderly: pitfalls and medical care. La Presse Médicale, Elsevier Masson, 2016, Presse medicale (Paris, France 1983), 45 (5), pp.522-531. ⟨10.1016/j.lpm.2015.12.013⟩. ⟨hal-02474403⟩

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