Delirium in patients with Parkinson's disease

Seek specialist advice when managing delirium in Parkinson's disease

• a major problem in the management of patients with Parkinson's disease can be drug-induced neuropsychiatric problems such as visual hallucinations and confusion
  
  
• drugs such as olanzapine have fewer extrapyrimadal side effects that other antipsychotic drugs and therefore are less likely to worsen parkisonism when used; however advice has stressed the concerns of using newer antipsychotics such as olanzapine and risperidone in the elderly (2)
  
  
• other causes of an acute confusional state should be considered

Reference:

1. Update (1998); 57(2): 122-30.
2. Summary - Guidance for the management of behavioural and psychiatric symptoms in dementia and the treatment of psychosis in people with history of stroke/TIA. Working group for the Faculty of Old Age Psychiatry RCPsych, RCGP, BGS, and Alzheimer's Society, following CSM restriction on risperidone and olanzapine. April 2004