Purpose of Review: This article reviews the recognition and management of neuropsychiatric issues in Parkinson disease (PD), including mood disorders, cognitive impairment, and behavioral disturbances.
Recent Findings: Patients with PD frequently develop neuropsychiatric issues, and these issues can greatly affect their quality of life. In recent years, mood, cognitive, and behavioral issues in PD have received greater recognition, with increasing attention directed toward improved screening and therapeutic interventions for symptomatic treatment. Taken together as a group, neuropsychiatric issues can be found throughout the whole course of PD, from early in the disease, potentially even in a premotor stage, to the time of diagnosis and later in the course with more advanced disease.
Summary: In the comprehensive care of patients with PD, recognition of neuropsychiatric issues is critical. Advances in therapeutics for the different neuropsychiatric symptoms are still needed, although several pharmacologic and nonpharmacologic options are available. Patient management frequently requires a multidisciplinary approach, with collaboration of neurologists with neuropsychologists, psychologists, psychiatrists, and other health professionals.
Address correspondence to Dr Jennifer G. Goldman, Rush University Medical Center, Department of Neurological Sciences, 1725 W Harrison St, Suite 755, Chicago, IL 60612, Jennifer_Goldman@rush.edu.
Relationship disclosure: Dr Goldman has received personal compensation for serving as a consultant for Acadia Pharmaceuticals Inc, Pfizer Inc, and Teva Pharmaceutical Industries Ltd. Dr Goldman receives research support from Acadia Pharmaceuticals Inc, Biotie Therapies, the Michael J. Fox Foundation, the National Institute of Neurological Disorders and Stroke/National Institutes of Health, and Teva Pharmaceutical Industries Ltd.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Goldman discusses the unlabeled/investigational use of antidepressants, antipsychotics, anxiolytics, and cognitive impairment medications for the treatment of Parkinson disease, none of which are approved by the US Food and Drug Administration except rivastigmine.