Parkinson’s disease (PD) is the second most common neurodegenerative disease seen in older adults after Alzheimer’s disease, with increasing prevalence worldwide. Parkinson’s disease psychosis (PDP) is a common, non-motor feature of PD, which increases caregiver stress and is a risk-factor for nursing home placement. In this paper we review PDP epidemiology, features, diagnosis, and treatment. PDP most often presents with sequential development of minor and then increasingly complex visual hallucinations mediated by dopaminergic-serotonergic interactions activating the mesolimbic pathway, with contributions from other structures and neurotransmitters. Appropriate evaluation of differential diagnoses for psychosis is vital before diagnosing PDP. Initial treatment should involve non-pharmacologic approaches. If these are unsuccessful and PDP symptoms significantly impact the patient’s and or their caregivers’ quality of life and functions, then pharmacotherapy is indicated. Pimavanserin is a recently FDA-approved pharmacologic treatment for PDP with a better profile of balanced effectiveness and safety compared to previous use of atypical antipsychotics. Early diagnosis and safer, more effective treatments for PDP should help reduce caregiver burden and enable caregivers to continue to provide care at home versus institutionalization.

帕金森病 (PD) 是继阿尔茨海默病之后老年人中第二常见的神经退行性疾病，在全球范围内患病率不断增加。帕金森病精神病 (PDP) 是 PD 的一种常见的非运动特征，会增加护理人员的压力，并且是安置疗养院的风险因素。在本文中，我们回顾了 PDP 的流行病学、特征、诊断和治疗。PDP 最常表现为由多巴胺能 - 5-羟色胺能相互作用介导的轻微幻觉，然后是越来越复杂的幻觉，激活中脑边缘通路，其他结构和神经递质也有贡献。在诊断 PDP 之前，适当评估精神病的鉴别诊断至关重要。初始治疗应涉及非药物方法。如果这些都不成功并且 PDP 症状显着影响患者和/或他们的护理人员的生活质量和功能，则需要药物治疗。Pimavanserin 是最近获得 FDA 批准的 PDP 药物治疗，与之前使用的非典型抗精神病药相比，具有更好的平衡有效性和安全性。PDP 的早期诊断和更安全、更有效的治疗应有助于减轻护理人员的负担，并使护理人员能够继续在家中提供护理而不是机构化。