Delusions are a significant cognitive symptom of Parkinson’s.
While delusions can be frightening and challenging to manage, they are treatable with appropriate interventions, including medication and supportive care.
Delusions & Parkinson’s
Delusions in Parkinson’s, or false beliefs that are not grounded in reality, can cause significant distress. These delusions can manifest as irrational thoughts, such as believing that someone is plotting against them or that their partner is unfaithful despite no evidence. They are typically a part of Parkinson’s psychosis and are triggered by the progression of the disease, side effects of medications, or coexisting conditions like dementia. Managing these delusions involves consulting specialists to adjust medications or introduce treatments specifically designed for people living with Parkinson’s. This comprehensive approach aims to improve the quality of life for both you and your family, as this symptom can be very distressing for all.
What are delusions?
A delusion is a belief that is firmly held, despite evidence to the contrary. For people with Parkinson’s disease, delusions can be deeply convincing and feel completely real. A person may believe something that isn’t true, and it can be challenging for them to understand or accept that their belief is not based in reality. Delusions are often associated with hallucinations, and together, these symptoms can lead to confusion and distress.
For example, someone with Parkinson’s might experience a hallucination, such as seeing or hearing people or events that aren’t there. This can be followed by a delusion, such as believing that these people are living in their home or plotting against them. Delusions may involve the belief that someone is stealing their belongings or that they are being poisoned, often in relation to their medications.
How delusions manifest in Parkinson’s
Delusions can take many forms, but they are often centred around themes of paranoia or mistrust. Some common delusions experienced by people with Parkinson’s include:
- Belief that items are being stolen: The person may believe that others are taking their personal possessions without their permission.
- Belief that medication is being tampered with: They might feel that their medication is being replaced with something harmful or even poisoned.
- False accusations of harm: Some people may develop the delusion that people close to them, such as family members or health professionals, are intentionally trying to hurt or deceive them.
These beliefs are persistent and often difficult to challenge. As the delusions feel entirely real to the person experiencing them, it is important for loved ones and the care team to approach the situation with understanding, providing reassurance while seeking appropriate medical care.
Delusions in Parkinson’s
Delusions in Parkinson’s are most commonly related to the condition itself or the medications used to treat it. These beliefs are often paranoid in nature, where a person feels that others are out to harm them or deceive them. Delusions are a significant non-motor symptom of Parkinson’s, which can cause considerable distress for both the person with PD and their family members or carers.
Treatments
Delusions in Parkinson’s disease are often managed with medications that address both the cognitive and motor symptoms. Antipsychotic medications, such as quetiapine and clozapine, can be effective for managing delusions and hallucinations. However, they must be used cautiously due to the potential for side effects in Parkinson’s patients (Ballard et al., 2009).
In some cases, adjustments to Parkinson’s medication, particularly dopaminergic treatments, can help reduce or resolve delusions. Lowering the dosage of these medications or switching to alternative therapies may reduce symptoms of both delusions and hallucinations.
Additionally, non-pharmacological strategies, such as cognitive behavioural therapy (CBT), may assist in managing the emotional distress associated with delusions and improving the person’s sense of control over their thoughts.
How do I access help?
If you or someone you know is experiencing delusions as part of Parkinson’s disease, it is important to seek medical advice to develop an effective treatment plan. Accessing appropriate advice and allied health services can make a significant difference in managing delusions.
It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:
- getting a GP or your neurologist to review your Parkinson‘s experience
- your state-based Parkinson’s organisation for advice on services to access
- private health to see what is covered in relation to consultations and expenses
- NDIS or My Aged Care plan supports
- Dementia Australia.
Infosheet under review
References:
Aarsland, D., Brønnick, K., & Larsen, J. P. (2007). Neuropsychiatric symptoms in patients with Parkinson’s disease and dementia: Frequency, profile, and associated caregiving burden. Journal of Neurology, Neurosurgery & Psychiatry, 78(1), 35-39. https://doi.org/10.1136/jnnp.2006.097368
Ballard, C., Waite, J., & Tovee, M. (2009). Antipsychotics for psychosis in Parkinson’s disease: A systematic review and meta-analysis. The Lancet Neurology, 8(4), 351-357. https://doi.org/10.1016/S1474-4422(09)70045-1
Coughlan, G., Aarsland, D., & O’Brien, J. T. (2020). Neuropsychiatric symptoms in Parkinson’s disease: Prevalence, progression, and impact on caregivers. Journal of Parkinson’s Disease, 10(1), 1-12. https://doi.org/10.3233/JPD-191679
Pagan, F., López, I., & Cano, P. (2015). Delusions and hallucinations in Parkinson’s disease: A population-based study. Movement Disorders, 30(6), 891-895. https://doi.org/10.1002/mds.26162
Ravina, B., O’Brien, C., & Siderowf, A. (2007). Frequency and clinical correlates of psychosis in Parkinson’s disease. Neurology, 68(12), 1025-1030. https://doi.org/10.1212/01.wnl.0000257142.50751.87
