Which medication is used for psychosis or hallucinations of Parkinson's disease?

Which medication is used for psychosis or hallucinations of Parkinson's disease?

• A. Clozapine
• B. Risperidone
• C. Olanzapine
• D. Ziprasidone

Answer: (A)

In Parkinson's disease, treating psychosis or hallucinations requires an antipsychotic that minimizes disruption of motor function. Clozapine has this favorable balance because it provides antipsychotic effects with relatively weak blocking of D2 receptors in the nigrostriatal pathway, so it tends to reduce hallucinations without worsening Parkinsonian motor symptoms. Its effectiveness in PD-related psychosis, especially when other antipsychotics risk increasing motor problems, makes it the preferred choice. However, it carries a significant safety requirement: regular blood monitoring due to the risk of agranulocytosis, which means clinicians must supervise blood counts closely. The other options can worsen motor symptoms through stronger D2 blockade and may have less proven benefit for PD psychosis, along with other risks like extrapyramidal symptoms, weight gain, or QT prolongation.

In Parkinson's disease, treating psychosis or hallucinations requires an antipsychotic that minimizes disruption of motor function. Clozapine has this favorable balance because it provides antipsychotic effects with relatively weak blocking of D2 receptors in the nigrostriatal pathway, so it tends to reduce hallucinations without worsening Parkinsonian motor symptoms. Its effectiveness in PD-related psychosis, especially when other antipsychotics risk increasing motor problems, makes it the preferred choice. However, it carries a significant safety requirement: regular blood monitoring due to the risk of agranulocytosis, which means clinicians must supervise blood counts closely. The other options can worsen motor symptoms through stronger D2 blockade and may have less proven benefit for PD psychosis, along with other risks like extrapyramidal symptoms, weight gain, or QT prolongation.