Antiparkinsonian drugs and visual hallucinations.

摘要

Williams and Lees' study, which is unique because of the impressive sample size and autopsy control, clearly established a strong relation between visual hallucinations and the presence of Lewy-body pathology in Parkinson's disease. The results will probably become a milestone in the operational clinical criteria for the diagnosis of Parkinson's disease, arid the presence of visual hallucinations should be regarded as a new red flag from now on.The results strongly challenge the common notion that visual hallucinations in Parkinson's disease aremainly related to antiparkinsonian chronic treatment and probably occur as a drug-induced adverse effect in the frame of a multifactorial origin, as suggested in an evidence-based review.2 Indeed, Williams and Lees showed only weak correlations between visual hallucinations and the use of selegiline and ergot dopamine agonists, and no association at all with the use of levodopa, non-ergot dopamine agonists, amantadine, and anticholinergic drugs.