Recognizing and treating neuropsychiatric symptoms in parkinson's disease

• Objective: To review the clinical characteristics, epidemiology, and management of the most common neuropsychiatric symptoms (NPS) in Parkinson's disease (PD). • Methods: Literature review. • Results: PD has traditionally been considered a disease of impaired motor function. However, neuropsychiatric complications, such as fatigue, depression, anxiety, psychosis, impulse control disorders, and apathy, frequently complicate the course of the illness. Although the development of new medication options in recent years has had a positive benefit on the management of these troublesome symptoms, responses are frequently suboptimal. The development of valid instruments to measure neuropsychiatric symptoms has been vital in research efforts to bridge the gaps in our understanding. Further elucidation of neuropsychiatric pathophysiologies will help to define treatment targets and has the potential to expand our therapeutic armamentarium. • Conclusion: While NPS affect patients with established disease, recent investigations have demonstrated risk of symptoms in those with early untreated stages of PD; therefore, better understanding of NPS should be the goal of practitioners treating the entire continuum of PD.