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Parkinson disease psychosis — RACP Written MCQ

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HardNeurologyParkinson disease psychosisRACP Written

A 66-year-old man has tremor at rest, bradykinesia and rigidity. His family reports hallucinations after starting a dopamine agonist, and he has troublesome wearing-off on levodopa. What is the most appropriate management?

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Correct answer: E — Review dopaminergic regimen and reduce psychosis-provoking therapy while optimising levodopa

Dopamine agonists commonly worsen hallucinations in Parkinson disease. Medication review should reduce offending agents while preserving motor control.

Reference: Australian stroke and neurology guideline principles; Therapeutic Guidelines