MODERN APPROACHES TO THE TREATMENT OF PSYCHOTIC DISORDERS IN PARKINSON'S DISEASE

Abstract

Psychotic disorders in Parkinson's disease (PDPD) are observed in a large number of patients. They have a significant impact on the quality of life and the level of disability. The pathogenesis of PDPD is complex and not fully understood. Taking into account the specificity of PD (usually elderly patients with a risk of cognitive impairment), as well as the pharmacodynamic features of antiparkinsonian and classical antipsychotic drugs, the treatment of PDPD requires special attention from neurologists and psychiatrists. This systematic review summarizes the results of scientific publications for the period 2014-2016 in two bibliographic databases: MEDLINE/PubMed and eLIBRARY.RU, as well as clinical guidelines of the International Parkinson's Disease and Movement Disorders Society, the American and European Academies of Neurology. Of the antipsychotic drugs, clozapine is a drug recommended for use, quetiapine is a drug that is recognized as possible for use, pimavanserin is likely to become one of the drugs of choice in the treatment of PDPD. Non-pharmacological treatments have shown positive effects in terms of improving the general condition of patients with PD, but their effectiveness in treating PD itself remains unclear.