Parkinson's Disease Psychosis: Dr. Daniel Kremens Explains Hallucinations, New Drug

A little-known aspect of Parkinson's Disease, according to a neurologist in Philadelphia, is the fact that about half of the one million people who have it will develop Parkinson's disease psychosis, which he describes as "delusions and hallucinations," at some point during the course of their illness.

"Parkinson's disease has both motor and non-motor symptoms. And the general population thinks about Parkinson's as just a motor illness: tremor, rigidity, problems with walking. But the fact of the matter is that for many patients, the non-motor symptoms are even more troublesome."
Dr. Daniel Kremens, a neurologist and co-director of the Parkinson's Disease and Movement Disorders Center at Jefferson Medical College of Thomas Jefferson University in Philadelphia, took some time out from attending the World Parkinson's Congress in Oregon to discuss the issue of Parkinson's disease psychosis.

Joining Dr. Kremens for the interview was Jody Wade, an adult child caregiver for her mother who had suffered with the hallucinations and delusions from Parkinson's disease psychosis, until she talked to a doctor about it.

"I picked up on my mom's hallucinations about a year after her initial diagnosis. And I picked up on it early because I had some prior experience. My friend's mom suffered from the same thing."
Wade continues.
"My mom showed no signs of dementia. Her memory was intact, everything else was good, except that she had these false beliefs and hallucinations that became frightening quickly."
One time it became clear to Wade that things had become too much for her mother.
"They escalated to the point where she actually called the police in the middle of the night and we could no longer leave her alone."
Her family had enough members in it that they could all take turns staying overnight with their mom. Wade said it was clear "she was really very, very scared." Wade adds that she was able to discuss the problem with a doctor, and she discovered there was a medicine which has been "very successful for my mother."

"What Jody describes is pretty typical," Dr. Kremens. "What happens in this condition is the hallucinations begin, and they are initially described as 'benign.' So, people have insight into them, they realize they are hallucinations and they're not actually there."

Over time patients may lose that insight, however, he adds.

"But over time that insight is lost, and the hallucinations become frightening."
It seems to be what happened to Jody's mom, said the doctor. "She would start to see intruders in the house, she got very scared, and that's when this condition can become very devastating."

From Twitter, mention is made of Parkinson's disease psychosis.

"As Jody pointed out, we now have a new medicine that's FDA (Federal Drug Administration) approved for the treatment of hallucinations and delusions with Parkinson's disease."
The drug is called "Nuplazid," and is mentioned over at the Neurology Advisor website because it treats the psychosis while it does not seem to worsen a patient's motor functions, per the statement released by Michael S. Okun, MD, Medical Director of The National Parkinson Foundation.
"Today's approval of Nuplazid represents a major paradigm shift in the treatment of Parkinson's disease psychosis. Through its novel and selective mechanism of action, Nuplazid is a breakthrough treatment that works in a whole new way— treating hallucinations and delusions without blocking dopamine receptors and, therefore, not impairing motor function in Parkinson's psychosis patients."
Dr. Kremens also said during the interview that he wanted to raise awareness of the point that the drug "... allows us to treat the hallucinations and delusions associated with Parkinson's Disease psychosis without worsening those motor symptoms that I was talking about earlier."

Tracy Pollan, Michael J. Fox, Christopher Lloyd, Lisa Loiacono
Actor Michael J. Fox and wife Tracy Pollan, left, pose with actor Christopher Lloyd and girlfriend Lisa Loiacono to benefit The Michael J. Fox Foundation for Parkinson’s Research in New York. [Image by Evan Agostini/Invision/AP Images]

Should any person be diagnosed with Parkinson's disease, one of the first things he or she should do "... is make sure you can get treated by a movement disorder specialist," Dr. Kremens said. "A movement disorder specialist is a neurologist with advanced training specifically in Parkinson's."

The next piece of advice the neurologist mentions is regarding those Parkinson's disease patients who are "afraid" to share with their doctor that they are hallucinating. He is encouraging patients to be willing to share the symptoms with their physicians.

"A lot of times patients are afraid to share the fact that they are hallucinating, because they are concerned that people will think they are crazy or won't believe them. And so, we as physicians have to let people know that this is part of the disease and patients shouldn't be afraid to tell us."
IMAGE DISTRIBUTED FOR THE MICHAEL J. FOX FOUNDATION FOR PARKINSON'S RESEARCH - Squire Barnes, Michael J. Fox and ultra-athlete Sam Fox (no relation) in Vancouver, BC, on Saturday, September 12. [Image By The Michael J. Fox Foundation for Parkinson’s Research / Christine McAvoy/AP Images]

One celebrity waging his own big war on Parkinson's disease has been actor Michael J. Fox, and he seems to be doing well these days, picking up a guitar and performing alongside musician John Fogarty.

In light of the newest FDA-approved Acadia Pharmaceutical medicine now for the Parkinson's disease psychosis, which has also been mentioned as of interest for the treatment of Alzheimer's issues over at the investing website MotleyFool, patients should find out more about the treatment option which could help them deal with hallucinations and delusions associated with their own battle with disease.

And, while there is no data available on how to prevent the disease, Dr. Kremens suggests living "a healthy lifestyle" and maybe drinking a bit of coffee.

[Featured Image used with permission of Tiffany Miller, publicist]