A guide to management of neuropsychiatric manifestations of Parkinson's disease

Objective: This clinical update review focuses on treatment approaches of neuropsychiatric manifestations in Parkinson's disease. Methods: We conducted a systematic search of the literature using Pubmed and selected recent and relevant papers for this review. Results: Neuropsychiatric symptoms in Parkinson's disease usually require optimization of levodopa therapy as a first step. Most psychotropic drugs can be used in Parkinson's disease, however there is still lack of an evidence base due to limited studies and difficulties in diagnosis of neuropsychiatric disorders. Non-pharmacological treatments have also proved effective in Parkinson's disease. Cognitive impairment requires special consideration. Conclusions: Management of neuropsychiatric manifestations in Parkinson's disease is complicated by the lack of evidence. Treatment should be individualized and benefits and risks must be balanced.