“It could be worse,” we say to each other. In the Parkinson’s (PD) community, discussion on the discomfort of Parkinson’s disease is shared with a self-avowed obligation to keep spirits high. Shaking hands, dyskinesia, a slow gait, speech problems, are a few of the well-known Parkinson disease motor symptoms that worry us. Our positive spin contributes to helping us feel better.

Underneath the good vibe however, there is a non-motor side effect to Parkinson’s that I’ve been stressing about lately. Recently, I’ve been reading up on psychosis because a family member of mine has schizophrenia.

Schizophrenia is a mental illness that causes psychosis. A person experiencing an episode of psychosis ‘breaks’ with reality when a jumble of confusing thoughts, images, and sounds in their mind produces a strange and shocking reaction that affects the people around them.

Psychosis is a non-motor side effect, present in Parkinson’s patients who’ve had the disease usually with more severity than the garden variety sort of PD.

I’ve always thought that psychosis is a problem I don’t have to worry about for myself. I surmised that schizophrenia equals too much oversensitivity to dopamine receptors while Parkinson’s disease equals not enough dopamine in the brain. As a PD person, I’m low on dopamine so psychosis would never be my problem. Not impossible!

Research shows their opposing pathophysiology alone makes schizophrenia and PD seemingly impossible; yet, they do coexist rarely in clinical practice.

Parkinson’s psychosis may be triggered by the medications or dementia that alters the balance of chemicals in the brain. While increased dopamine lessens motor symptoms in most Parkinson’s people, it can also stimulate brain areas that lead to psychosis.

Parkinson’s disease (PD) psychosis has been in the news since Nuplazid (pimavanserin) was approved by the U.S. Food and Drug Administration in April 2016. Nuplazid is the first drug indicated for PD psychosis.

It is good to know that there is the possibility of a treatment for those with uncontrolled psychosis. One more thing to put on a good spin on for the future. It could be worse.



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