Parkinson's Disease Dementia – Cholinesterase Inhibitors — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurodegenerative DiseaseParkinson's Disease Dementia – Cholinesterase InhibitorsSCE Neurology

A 72-year-old man with a 3-year history of Parkinson's disease develops progressive dementia with prominent visual hallucinations. He meets criteria for PDD. NICE guidance recommends which class of medication for his cognitive and neuropsychiatric symptoms?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Cholinesterase inhibitor (rivastigmine or donepezil)

NICE NG71 recommends cholinesterase inhibitors (rivastigmine is the only one licensed for PDD; donepezil may also be used) for Parkinson's disease dementia. These improve cognition, behavioural symptoms, and activities of daily living. A: SSRIs treat depression but not the cognitive/hallucinatory symptoms of PDD. C: Memantine has limited evidence in PDD and is not first-line. D: Antipsychotics (except quetiapine/clozapine) are contraindicated in PD/DLB due to severe sensitivity reactions. E: Dopamine agonists may worsen hallucinations.

Reference: NICE NG71 Parkinson's Disease (2017); NICE NG97 Dementia (2018)