COMPREHENSIVE REVIEW IN PSYCHOSIS OF PARKINSON DISEASE: PATHOPHYSIOLOGY, BEST THERAPY, AND PROGNOSIS
Ervina Arta Jayanti Hutabarat1*, Suroto1, Diah Kurnia Mirawati1, Subandi1, Rivan Danuaji1, Pepi Budianto1, Yetty Hambarsari1, Baarid Luqman Hamidi1, Hanindia Riani P1, Ira Ristinawati1, Teddy Tejomukti1, Andi Ario Tedjo1, and Fabian Jeremy Prasetyo2

1 Department of Neurology, Faculty of Medicine, Sebelas Maret University, Indonesia
2 Faculty of Medicine, Sebelas Maret University, Indonesia

Abstract

ABSTRACT
Among the non-motor symptoms of Parkinson disease, psychosis is one of the most common, complex, and disabling non-motor symptoms, with an estimated prevalence of up to 43-63% in the advanced stages of Parkinson disease. The prevalence of psychosis in Parkinson disease increases as the disease progresses and is associated with poorer quality of life, disability, and increased caregiver stress, as well as increased cognitive decline, hospitalization rates, morbidity, and mortality. Psychosis not only occurs naturally in the disease progression but is also caused by Parkinson disease medication itself, dopamine-related therapy. Our group reviewed literature specifically about psychosis in Parkinson disease. Key topics include the pathophysiology of psychosis in Parkinson disease, the causal mechanism of psychosis by Parkinson disease medication, and also the best principle of therapy in patients with psychosis in Parkinson disease. Numerous literary works discuss the fundamentals of treating psychosis in Parkinson disease, which also includes using anti-psychotic drugs such as pimavanserin, clozapine, and quetiapine. Psychosis in Parkinson disease has become a unique challenge for clinicians to overcome how Parkinson disease medication can become the cause of psychosis, so this raises questions and directions for future research to come.

Keywords: Parkinson disease, psychosis, dopamine, dopamine-related therapy

Topic: Medical : basic science, clinical, translational research, medical education, and miscellaneous