Parkinson's Disease and Mental Health
How Are These Mental Disturbances Treated?
The first step is to address any other medical conditions that could produce hallucinations, delusions, or paranoia. Your doctor will check for imbalances in the chemicals of the blood that help control water levels in the body and help with transmitting nerve impulses. He or she may also check your kidney, liver, or lung function, as well as screen for certain infections since these problems could cause mental disturbances. Other medications that you may be using, including over-the-counter drugs, could also be responsible for these disturbances. Be sure to tell your doctor about all medications, including herbal therapies, that you are taking.
Many times, the medications used to treat Parkinson's disease can cause these mental disturbances. Switching to different Parkinson's disease medication can sometimes control these disturbances.
Some people may not be able to tolerate changes in their Parkinson's disease medications without increasing their symptoms. In these cases, it may be necessary to treat the mental disturbances with anti-psychotic medicines. However, there is a risk that traditional anti-psychotic medicines can worsen Parkinson's disease. Fortunately, there are other alternatives. The medication pimavanserin (Nuplazid) was approved specifically to treat the psychosis associated with Parkinson’s disease. Other medications such as Zyprexa, Seroquel, and Clozaril can effectively control hallucinations at low doses without worsening Parkinson's disease symptoms. Clozaril is the least likely to worsen Parkinson's symptoms; but, unfortunately, there is a small chance (about 2%) that your white blood cell (cells that fight infection) count will drop. For this reason, your doctor will likely perform frequent blood tests to make sure your white blood cells stay at a certain level.
If you are feeling depressed or experiencing any of the mentioned mental disturbances, talk to your doctor right away. There is likely a remedy that will make you feel better.