Neuropsychiatric Complications of Parkinson Disease Treatments: Importance of Multidisciplinary Care.

Am J Geriatr Psychiatry
Authors
Abstract

Although Parkinson disease (PD) is defined clinically by its motor symptoms, it is increasingly recognized that much of the disability and worsened quality of life experienced by patients with PD is attributable to psychiatric symptoms. The authors describe a model of multidisciplinary care that enables these symptoms to be effectively managed. They describe neuropsychiatric complications of PD itself and pharmacologic and neurostimulation treatments for parkinsonian motor symptoms and discuss the management of these complications. Specifically, they describe the clinical associations between motor fluctuations and anxiety and depressive symptoms, the compulsive overuse of dopaminergic medications prescribed for motor symptoms (the dopamine dysregulation syndrome), and neuropsychiatric complications of these medications, including impulse control disorders, psychosis, and manic syndromes. Optimal management of these problems requires close collaboration across disciplines because of the potential for interactions among the pathophysiologic process of PD, motor symptoms, dopaminergic drugs, and psychiatric symptoms. The authors emphasize how their model of multidisciplinary care facilitates close collaboration among psychiatrists, other mental health professionals, neurologists, and functional neurosurgeons and how this facilitates effective care for patients who develop the specific neuropsychiatric complications discussed.

Year of Publication
2016
Journal
Am J Geriatr Psychiatry
Volume
24
Issue
12
Pages
1171-1180
Date Published
2016 Dec
ISSN
1545-7214
DOI
10.1016/j.jagp.2016.08.017
PubMed ID
27746069
PubMed Central ID
PMC5136297
Links
Grant list
K23 AG044441 / AG / NIA NIH HHS / United States