Review Article | Published:

Hallucinations in Parkinson disease

Nature Reviews Neurology volume 5, pages 331342 (2009) | Download Citation

Abstract

Patients with Parkinson disease (PD) can experience hallucinations (spontaneous aberrant perceptions) and illusions (misinterpretations of real perceptual stimuli). Of such phenomena, visual hallucinations (VHs) and illusions are the most frequently encountered, although auditory, olfactory and tactile hallucinations can also occur. In cross-sectional studies, VHs occur in approximately one-third of patients, but up to three-quarters of patients might develop VHs during a 20-year period. Hallucinations can have substantial psychosocial effects and, historically, were the main reason for placing patients in nursing homes. Concomitant or overlapping mechanisms are probably active during VHs, and these include the following: central dopaminergic overactivity and an imbalance with cholinergic neurotransmission; dysfunction of the visual pathways, including specific PD-associated retinopathy and functional alterations of the extrastriate visual pathways; alterations of brainstem sleep–wake and dream regulation; and impaired attentional focus. Possible treatments include patient-initiated coping strategies, a reduction of antiparkinson medications, atypical neuroleptics and, potentially, cholinesterase inhibitors. Evidence-based studies, however, only support the use of one atypical neuroleptic, clozapine, and only in patients without dementia. Better phenomenological discrimination, combined with neuroimaging tools, should refine therapeutic options and improve prognosis. The aim of this Review is to present epidemiological, phenomenological, pathophysiological and therapeutic aspects of hallucinations in PD.

Key points

  • According to cross-sectional studies, one-third of individuals with Parkinson disease (PD) experience visual hallucinations; however, up to 75% of patients will develop such phenomona over a 20-year period

  • Hallucinations have substantial psychosocial effects and are a prominent factor influencing the placement of patients with PD in nursing homes

  • Hallucinations usually occur in the context of dopaminergic or anticholinergic drug therapy for PD

  • Multifaceted visual deficits, sleep–wake cycle dysregulation and cognitive dysfunction are increasingly recognized as contributory factors to hallucinations in PD

  • Treatments for hallucinations include atypical neuroleptics and, possibly, cholinesterase inhibitors

  • In the future, a more discriminative phenomenological exploration could delineate distinct types of hallucinations with differing pathophysiological mechanisms, treatment strategies, and prognoses

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References

  1. 1.

    , & Hallucinations in Parkinson disease in the prelevodopa era. Neurology 66, 93–98 (2006).

  2. 2.

    , 3rd & Levodopa induced psychosis: a kindling phenomenon. Am. J. Psychiatry 135, 669–675 (1978).

  3. 3.

    et al. Visual hallucinations in Parkinson's disease: clues to separate origins. J. Neurol. Sci. 248, 143–150 (2006).

  4. 4.

    Paralysis Agitans. A Clinical and Genetic Study (Ejnar Munksgaard, Copenhagen, 1949).

  5. 5.

    , & Psychiatric symptoms and syndromes in Parkinson's disease. Am. J. Psychiatry 107, 901–907 (1951).

  6. 6.

    , , & Effects of levodopa in parkinsonian patients with dementia. Neurology 22, 516–519 (1972).

  7. 7.

    & Psychiatric disturbances in Parkinson's disease. Dis. Nerv. Syst. 33, 577–583 (1972).

  8. 8.

    Hallucinations in Parkinson's disease: the clinical syndrome. Adv. Neurol. 80, 419–423 (1999).

  9. 9.

    , & Acute postoperative confusion and hallucinations in Parkinson's disease. Ann. Intern. Med. 111, 218–222 (1989).

  10. 10.

    et al. DLB and PDD boundary issues: diagnosis, treatment, molecular pathology, and biomarkers. Neurology 68, 812–819 (2007).

  11. 11.

    et al. Characteristics of visual hallucinations in Parkinson disease dementia and dementia with lewy bodies. Am. J. Geriatr. Psychiatry 14, 153–160 (2006).

  12. 12.

    , & Visual hallucinations in Parkinson and Charles Bonnet Syndrome patients. A phenomenological and pathogenetic comparison [German]. Fortschr. Neurol. Psychiat. 68, 129–136 (2000).

  13. 13.

    & Visual hallucinations in Parkinson's disease: a review and phenomenlogical survey. J. Neurol. Neurosurg. Psychiatry 70, 727–733 (2001).

  14. 14.

    , & Prospective study of hallucinations and delusions in Parkinson's disease. J. Neurol. Neurosurg. Psychiatry 70, 734–738 (2001).

  15. 15.

    , , & Hallucinations in Parkinson's disease. Prevalence, phenomenology and risk factors. Brain 123, 733–745 (2000).

  16. 16.

    , & Hallucinosis in idiopathic Parkinson's disease. J. Neurol. Neurosurg. Psychiatry 63, 434–440 (1997).

  17. 17.

    , & Auditory hallucinations in Parkinson's disease. J. Neurol. Neurosurg. Psychiatry 64, 533–535 (1998).

  18. 18.

    , , , & Tactile hallucinations in Parkinson's disease. J. Neurol. 249, 1699–1703 (2002).

  19. 19.

    et al. Drug-induced psychosis in Parkinson disease: phenomenology and correlations among psychosis rating instruments. Clin. Neuropharmacol. 28, 215–219 (2005).

  20. 20.

    , , & Age-related influences on the clinical characteristics of new-onset hallucinations in Parkinson's disease patients. Mov. Disord. 21, 267–270 (2006).

  21. 21.

    et al. Psychiatric comorbidities in patients with Parkinson disease and psychosis. Neurology 63, 293–300 (2004).

  22. 22.

    , , , & Relationship between age and subtypes of psychotic symptoms in Parkinson's disease. J. Neurol. 254, 448–452 (2007).

  23. 23.

    , , & Hallucinations and sleep disorders in PD: six-year prospective longitudinal study. Neurology 64, 81–86 (2005).

  24. 24.

    et al. A prospective study of delusional misidentification syndromes in Parkinson's disease with dementia. Mov. Disord. 23, 443–448 (2008).

  25. 25.

    et al. Diagnostic criteria for psychosis in Parkinson's disease: report of an NINDS, NIMH work group. Mov. Disord. 22, 1061–1068 (2007).

  26. 26.

    et al. Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 66, 996–1002 (2006).

  27. 27.

    et al. Scales to assess psychosis in Parkinson's disease: critique and recommendations. Mov. Disord. 23, 484–500 (2008).

  28. 28.

    et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov. Disord. 23, 2129–2170 (2008).

  29. 29.

    , & Using the presence of visual hallucinations to differentiate Parkinson's disease from atypical parkinsonism. J. Neurol. Neurosurg. Psychiatry 79, 652–655 (2008).

  30. 30.

    Hallucinations in Parkinson's disease: characteristics and associated features. Int. J. Geriatr. Psych. 10, 487–495 (1995).

  31. 31.

    , , & Prevalence and clinical correlates of psychotic symptoms in Parkinson disease. A community-based study. Arch. Neurol. 56, 595–601 (1999).

  32. 32.

    , , , & Parkinson Study Group CALM-PD Investigators. Risk factors for somnolence, edema, and hallucinations in early Parkinson disease. Neurology 69, 187–195 (2007).

  33. 33.

    , , , & The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years. Mov. Disord. 23, 837–844 (2008).

  34. 34.

    , , , & Prospective longitudinal assessment of hallucinations in Parkinson's disease. Neurology 57, 2078–2082 (2001).

  35. 35.

    , , , & The malignant course of “benign hallucinations” in Parkinson disease. Arch. Neurol. 63, 713–716 (2006).

  36. 36.

    et al. A profile of neuropsychiatric problems and their relationship to quality of lifefor PD patients without dementia. Parkinsonism Relat. Disord. 14, 37–42 (2008).

  37. 37.

    & Risk factors for nursing home placement in advanced Parkinson's disease. Neurology 43, 2227–2229 (1993).

  38. 38.

    , , & Predictors of nursing home placement in Parkinson's disease: a population-based, prospective study. J. Am. Geriatr. Soc. 48, 938–942 (2000).

  39. 39.

    et al. Longitudinal outcome of Parkinson's disease patients with psychosis. Neurology 60, 1756–1761 (2003).

  40. 40.

    & Risk and incidence of dementia in a cohort of older subjects with Parkinson's disease in the United Kingdom. Mov. Disord. 19, 1043–1049 (2004).

  41. 41.

    , & Clinical phenotype of Parkinson disease dementia. Neurology 67, 1605–1611 (2006).

  42. 42.

    et al. Antiparkinsonian medication is not a risk factor for the development of hallucinations in Parkinson's disease. J. Neural Transm. 111, 1447–1453 (2004).

  43. 43.

    , & Visual hallucinations associated with Parkinson's disease. Arch. Neurol. 53, 1265–1268 (1996).

  44. 44.

    et al. Intravenous levodopa in hallucinating Parkinson's disease patients: high-dose challenge does not precipitate hallucinations. Neurology 50, 515–517 (1998).

  45. 45.

    et al. Dopamine agonists in the treatment of early Parkinson's disease: a meta-analysis. Parkinsonism Relat. Disord. doi:10.1016/j.parkreldis.2008.07.004 (2008).

  46. 46.

    , & Pharmacology of hallucinations induced by long-term drug therapy. Am. J. Psych. 139, 494–497 (1982).

  47. 47.

    et al. Evidence of a monoaminergic- cholinergic imbalance related to visual hallucinations in Lewy Body Dementia. J. Neurochem. 55, 1454–1456 (1990).

  48. 48.

    , & Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe. Brain 125, 391–403 (2002).

  49. 49.

    et al. Cholinergic and dopaminergic activities in senile dementia of Lewy body type. Alzheimer Dis. Assoc. Disord. 4, 87–95 (1990).

  50. 50.

    et al. Delusions associated with elevated muscarinic binding in dementia with Lewy bodies. Ann. Neurol. 48, 868–876 (2000).

  51. 51.

    & Cholinergic and other neurotransmitter mechanisms in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies. Mov. Disord. 22 (Suppl. 17), S351–S357 (2007).

  52. 52.

    & Acetylcholine and hallucinations: disease-related compared to drug-induced alterations in human consciousness. Brain Cogn. 28, 240–258 (1995).

  53. 53.

    & Cortical acetylcholine, reality distortion, schizophrenia, and Lewy Body Dementia: too much or too little cortical acetylcholine? Brain Cogn. 38, 297–316 (1998).

  54. 54.

    & Dopamine action and disorders of neurotransmitter balance. Gerontology 33, 168–171 (1987).

  55. 55.

    , , & Treatment with tryptophan of levodopa-associated psychiatric disturbances. Arch. Neurol. 37, 155–156 (1980).

  56. 56.

    , , & L-tryptophan administration in L-dopa induced hallucinations in elderly Parkinsonian patients. Gerontology 23, 438–444 (1977).

  57. 57.

    & Pimavanserin tartrate: a 5-HT2A inverse agonist with potential for treating various neuropsychiatric disorders. Expert Opin. Pharmacother. 9, 3251–3259 (2008).

  58. 58.

    , & Hallucinations in Parkinson's disease: a follow-up study. Mov. Disord. 20, 212–217 (2005).

  59. 59.

    & Selective diplopia in Parkinson's disease: a special subtype of visual hallucination? Mov. Disord. 22, 1175–1178 (2007).

  60. 60.

    et al. Impaired visual acuity as a risk factor for visual hallucinations in Parkinson's disease. J. Geriatr. Psychiatry Neurol. 19, 36–40 (2006).

  61. 61.

    et al. Visual perception in Parkinson disease dementia and Lewy body dementia. Neurology 63, 2091–2096 (2004).

  62. 62.

    , , & Progressive worsening of spatial and chromatic processing deficits in Parkinson's disease. Arch. Neurol. 59, 1249–1252 (2002).

  63. 63.

    et al. Independent patterns of damage within magno-, parvo- and koniocellular pathways in Parkinson's disease. Brain 128, 2260–2271 (2005).

  64. 64.

    , , & Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 66, 845–851 (2006).

  65. 65.

    et al. Poor visual discrimination and visual hallucinations in Parkinson's disease. Clin. Neuropharmacol. 21, 289–295 (1998).

  66. 66.

    & A model of the parkinsonian visual system: support for the dark adaptation hypothesis. Vision Res. 40, 1937–1946 (2000).

  67. 67.

    Visual loss as a causative factor in visual hallucinations associated with Parkinson's disease. Arch. Neurol. 54, 799 (1997).

  68. 68.

    & The role of input relevance in sensory isolation. Am. J. Psychiatr. 122, 920–928 (1966).

  69. 69.

    , , , & Reality monitoring and visual hallucinations in Parkinson's disease. Neuropsychologia 41, 565–574 (2003).

  70. 70.

    , & Impaired recognition of facial expressions of anger in Parkinson's disease patients acutely withdrawn from dopamine replacement therapy. Neuropsychologia 45, 65–74 (2007).

  71. 71.

    et al. Facial expression recognition in people with medicated and unmedicated Parkinson's disease. Neuropsychologia 41, 1047–1057 (2003).

  72. 72.

    et al. Incidence of RBD and hallucination in patients affected by Parkinson's disease: 8-year follow-up. Neurol. Sci. 23 (Suppl. 2), S91–S94 (2002).

  73. 73.

    et al. Impaired visual search in drivers with Parkinson's disease. Ann. Neurol. 60, 407–413 (2006).

  74. 74.

    et al. Impaired navigation in drivers with Parkinson's disease. Brain 130, 2433–2440 (2007).

  75. 75.

    , , , & Sleep disruption and psychosis in chronic levodopa therapy. Clin. Neuropharmacol. 5, 183–194 (1982).

  76. 76.

    et al. Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease. Mov. Disord. 20, 1439–1448 (2005).

  77. 77.

    et al. Cognitive performance in REM sleep behavior disorder: a possible early marker of neurodegenerative disease? Sleep Med. 4, 343–351 (2008).

  78. 78.

    et al. REM sleep behavior disorder predicts cognitive impairment in Parkinson disease without dementia. Neurology 69, 1843–1849 (2007).

  79. 79.

    , & Polysomnographic sleep measures in Parkinson's disease patients with treatment- induced hallucinations. Ann. Neurol. 34, 710–714 (1993).

  80. 80.

    et al. Visual hallucinations as REM sleep behavior disorders in patients with Parkinson's disease. Mov. Disord. 18, 812–817 (2003).

  81. 81.

    et al. Hallucinations, REM sleep, and Parkinson's disease. Neurology 55, 281–288 (2000).

  82. 82.

    , & Repeated visual hallucinations in Parkinson's disease as disturbed external/internal perceptions: focused review and a new integrative model. Mov. Disord. 20, 130–140 (2005).

  83. 83.

    , & Update on the pharmacology of REM sleep behavior disorder. Neurology 67, 742–747 (2006).

  84. 84.

    et al. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol. Aging 24, 197–211 (2003).

  85. 85.

    New developments in the pathology of Parkinson's disease. Adv. Neurol. 53, 1–16 (1990).

  86. 86.

    et al. Hypocretin (orexin) loss in Parkinson's disease. Brain 130, 1577–1585 (2007).

  87. 87.

    , , , & Effect of time-of-day on the yawning response to apomorphine in normal subjects. Neuropsychobiology 41, 178–180 (2000).

  88. 88.

    et al. Dopaminergic control of sleep-wake states. J. Neurosci. 26, 10577–10589 (2006).

  89. 89.

    & Biologic rhythms and Parkinson's disease: a chronopharmacologic approach to considering fluctuations in function. Clin. Neuropharmacol. 25, 194–201 (2002).

  90. 90.

    , , & Circadian rest-activity rhythm is altered in Parkinson's disease patients with hallucinations. Mov. Disord. 23, 1137–1145 (2008).

  91. 91.

    et al. Hallucinations and sleep-wake cycle in PD: a 24-hour continuous polysomnographic study. Neurology 59, 1979–1981 (2002).

  92. 92.

    et al. Frontal dysfunction contributes to the genesis of hallucinations in non-demented Parkinsonian patients. Int. J. Geriatr. Psychiatry 20, 668–673 (2005).

  93. 93.

    et al. A neuropsychological longitudinal study in Parkinson's patients with and without hallucinations. Mov. Disord. 22, 2418–2425 (2007).

  94. 94.

    , Junqué, C., Martí, M. J., & Neuropsychological deficits in Parkinson's disease patients with visual hallucinations. Mov. Disord. 21, 1483–1487 (2006).

  95. 95.

    , , , & Neuropsychological predictors of hallucinations in Parkinson's disease: Cognitive and perceptual biases [abstract 538]. Mov. Disord. 22 (Suppl. 16), S166 (2007).

  96. 96.

    , , , & Visual object recognition and attention in Parkinson's disease patients with visual hallucinations. Mov. Disord. 23, 1906–1912 (2008).

  97. 97.

    et al. Fluctuations in attention. PD dementia vs DLB with parkinsonism. Neurology 59, 1714–1720 (2002).

  98. 98.

    & Visual hallucinations in the diagnosis of idiopathic Parkinson's disease: a retrospective autopsy study. Lancet Neurol. 4, 605–610 (2005).

  99. 99.

    , & Factors associated with drug-induced visual hallucinations in Parkinson's disease. J. Neurol. 252, 1223–1228 (2005).

  100. 100.

    , , , & Cognitive changes in Parkinson's disease patients with visual hallucinations. Dement. Geriatr. Cogn. Disord. 23, 281–288 (2007).

  101. 101.

    , , & Age-related influences on the clinical characteristics of new-onset hallucinations in Parkinson's disease patients. Mov. Disord. 21, 267–270 (2006).

  102. 102.

    & Depression as a cause of hallucinations in Parkinson's disease. Clin. Neuropharmacol. 8, 199–200 (1985).

  103. 103.

    , , & A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia. Int. J. Geriatr. Psychiatry 16, 528–536 (2001).

  104. 104.

    , & The apolipoprotein E epsilon 4 allele increases the risk of drug-induced hallucinations in Parkinson's disease. Clin. Neuropharmacol. 22, 226–230 (1999).

  105. 105.

    , & Apolipoprotein epsilon4 advances appearance of psychosis in patients with Parkinson's disease. Acta Neurol. Scand. 113, 14–17 (2006).

  106. 106.

    , , , & Genetic plymorphisms in Parkinson's disease subjects with and without hallucinations. Arch. Neurol. 61, 1280–1284 (2004).

  107. 107.

    et al. Genetic variation analysis in Parkinson disease patients with and without hallucinations: case-control study. Arch. Neurol. 58, 209–213 (2001).

  108. 108.

    et al. HLA typing does not predict REM sleep behavior disorder and hallucinations in Parkinson's disease. Mov. Disord. 18, 337–340 (2003).

  109. 109.

    et al. Visual hallucinations in Parkinson's disease are not influenced by polymorphismas of serotonin 5-HT2A receptor and transporter genes. Neurosci. Lett. 422, 228–231 (2007).

  110. 110.

    Functional neuroarchitecture of the retina: hypothesis on the dysfunction of retinal dopaminergic circuitry in Parkinson's disease. Surg. Radiol. Anat. 10, 137–144 (1988).

  111. 111.

    & Decreased dopamine in the retinas of patients with Parkinson's disease. Invest. Ophtalmol. Vis. Sci. 31, 2473–2475 (1990).

  112. 112.

    , , & Neurobiology of retinal dopamine in relation to degenerative states of the tissue. Vision Res. 37, 3509–3529 (1997).

  113. 113.

    , , & Retinal nerve fiber layer thinning in Parkinson disease. Vision Res. 44, 2793–2797 (2004).

  114. 114.

    , , , & Retinal involvement in dementia with Lewy bodies: a clue to hallucinations? Ann. Neurol. 54, 542–547 (2003).

  115. 115.

    et al. ERG and anatomical abnormalities suggesting retinopathy in dementia with Lewy bodies. Neurology 65, 1107–1110 (2005).

  116. 116.

    et al. Cerebral atrophy in Parkinson's disease patients with visual hallucinations. Eur. J. Neurol. 14, 750–756 (2007).

  117. 117.

    , , , & Cortical and amygdalar Lewy body burden in Parkinson's disease patients with visual hallucinations. Parkinsonism Relat. Disord. 12, 253–256 (2006).

  118. 118.

    , & Basic Vision. An Introduction to Visual Perception (Oxford University Press, Oxford, 2006).

  119. 119.

    et al. Altered cortical visual processing in PD with hallucinations: an fMRI study. Neurology 63, 1409–1416 (2004).

  120. 120.

    et al. Brain response to complex visual stimuli in Parkinson's patients with hallucinations: a functional magnetic resonance imaging study. Mov. Disord. 23, 2335–2343 (2008).

  121. 121.

    et al. Visual hallucination in Parkinson's disease with FDG PET. Mov. Disord. 19, 801–806 (2004).

  122. 122.

    et al. Regional cerebral blood flow in Parkinson disease with nonpsychotic visual hallucinations. Neurology 65, 1708–1715 (2005).

  123. 123.

    , , , & Visual hallucinations in psychologically normal people: Charles Bonnet's syndrome. Lancet 347, 794–797 (1996).

  124. 124.

    Visual hallucinations and the Charles Bonnet syndrome. Curr. Psychiatry Rep. 7, 168–179 (2005).

  125. 125.

    et al. The anatomy of conscious vision: an fMRI study of visual hallucinations. Nat. Neurosci. 1, 738–742 (1998).

  126. 126.

    Syndrome de la calotte du pédoncule cérébral. Les troubles psycho-sensoriels dans les lésions du mésencéphale [French]. Rev. Neurol. (Paris) 38, 1359–1365 (1922).

  127. 127.

    & Perceiving is believing: a Bayesian approach to explaining the positive symptoms of schizophrenia. Nat. Rev. Neurosci. 10, 48–58 (2009).

  128. 128.

    , & Why people see things that are not there: a novel perception and attention deficit model for recurrent complex visual hallucinations. Behav. Brain Sci. 28, 737–757 (2005).

  129. 129.

    & The cognitive neuroscience of sleep: neuronal systems, conciousness and learning. Nat. Rev. Neurosci. 3, 679–693 (2002).

  130. 130.

    , & Coping strategies for visual hallucinations in Parkinson's disease. Mov. Disord. 18, 831–832 (2003).

  131. 131.

    [No authors listed] Low-dose clozapine for the treatment of drug-induced psychosis in Parkinson's disease. The Parkinson Study Group. N. Engl. J. Med. 340, 757–763 (1999).

  132. 132.

    , , & Clozapine in Parkinson's disease psychosis: 5-year follow-up review. Clin. Neuropharmacol. 26, 8–11 (2003).

  133. 133.

    et al. Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up. J. Neurol. Neurosurg. Psychiatry 75, 689–695 (2004).

  134. 134.

    , , , & Olanzapine for the treatment of dopaminergic induced hallucinations. Mov. Disord. 20, 1031–1035 (2005).

  135. 135.

    , , , & Effect of quetiapine in psychotic PD patients: a double blind labeled study of 3 months' duration. Mov. Disord. 22, 313–318 (2007).

  136. 136.

    , , , & Rater-blinded, prospective comparison: quetiapine versus clozapine for Parkinson's disease psychosis. Clin. Neuropharmacol. 29, 331–337 (2006).

  137. 137.

    et al. Quetiapine improves psychotic symptoms and cognition in Parkinson's disease. Mov. Disord. 19, 29–35 (2004).

  138. 138.

    & Increased mortality among elderly patients with dementia using atypical antipsychotics. CMAJ 173, 252 (2005).

  139. 139.

    Risks and benefits of antipsychotic drugs in elderly patients with dementia. J. Psychosoc. Nurs. Ment. Health Serv. 46, 19–23 (2008).

  140. 140.

    , & Antipsychotic medication treatment for mild hallucinations in Parkinson's disease: positive impact on long-term worsening. Mov. Disord. 23, 1541–1545 (2008).

  141. 141.

    , , , & The beneficial effect of donepezil on visual hallucinations in three patients with Parkinson's disease. J. Geriatr. Psychiatry Neurol. 16, 184–188 (2003).

  142. 142.

    et al. Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson's disease. Mov. Disord. 21, 1899–1907 (2006).

  143. 143.

    , & Rivastigmine in dementia associated with Parkinson's disease and Alzheimer's disease: similarities and differences. J. Alzheimers Dis. 11, 509–514 (2007).

  144. 144.

    & Visual hallucinations predict increased benefits from rivastigmine in Parkinson's disease dementia. Nat. Clin. Pract. Neurol. 3, 250–251 (2007).

  145. 145.

    & Antidepressants in the treatment of psychosis with comorbid depression in Parkinson disease. Clin. Neuropharmacol. 27, 90–92 (2004).

  146. 146.

    & Antidepressant use in treatment of psychosis with comorbid depression in Parkinson's disease. Prog. Neuropsycholpharmacol. Biol. Psychiatry 31, 311–331 (2007).

  147. 147.

    , & Methamphetamine psychosis in which tardive dystonia was successfully treated with clonazepam. Psychiatry Clin. Neurosci. 61, 691–694 (2007).

  148. 148.

    , & Psychosis associated with clonazepam therapy for blepharospasm. J. Nerv. Ment. Dis. 170, 117–119 (1982).

  149. 149.

    , , & Interinctal acute psychosis in temporal lobe epilepsy during withdrawal of anticonvulsant therapy. J. Neurol. Neurosurg. Psychiatry 42, 724–730 (1979).

  150. 150.

    & Primary and secondary features of Parkinson's disease improve with strategic exposure to bright light: a case series study. Chronobiol. Int. 24, 521–537 (2007).

  151. 151.

    Parkinson's Disease. A Guide for Patient and Family (Raven, New York, 1991).

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Affiliations

  1. Department of Neurology, Center Hospitalier de Luxembourg, Luxembourg City, Luxembourg.

    • Nico J. Diederich
  2. Department of Neurology, CHU Henri Mondor, Créteil, France.

    • Gilles Fénelon
  3. Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.

    • Glenn Stebbins
    •  & Christopher G. Goetz

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Competing interests

Gilles Fénelon acts as a consultant for Boehringer–Ingelheim and Novartis Pharmaceuticals. Christopher G. Goetz has served as a consultant and advisory board member to Novartis Pharmaceuticals. The other authors declare no competing interests.

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Correspondence to Nico J. Diederich.

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https://doi.org/10.1038/nrneurol.2009.62

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