Black Kevin J
Departments of Psychiatry, Neurology, Radiology and Neuroscience, Washington University in St. Louis.
Med Int Rev. 2017 Dec;27(109):266-271. Epub 2018 Feb 3.
Early in the course of Parkinson disease (PD), treatment usually goes well. However, after five to ten years, things start to change as treatment requires higher doses of medications and side effects become more problematic. One of the most difficult problems is the development of hallucinations or delusions. Throughout the 20th century, treatment options were unproven and unsatisfactory, but the past 20 years have brought important changes. Two medications that are well tolerated in PD have now proved efficacious in randomized, controlled trials, and others are in development. Here I summarize this history briefly and provide a general plan for treating the patient with PD complicated by psychotic symptoms.
在帕金森病（PD）病程早期，治疗通常进展顺利。然而，五到十年后，情况开始发生变化，因为治疗需要更高剂量的药物，且副作用变得更成问题。最棘手的问题之一是出现幻觉或妄想。在整个20世纪，治疗方案未经证实且效果不佳，但在过去20年里出现了重要变化。两种在PD中耐受性良好的药物现已在随机对照试验中证明有效，其他药物也在研发中。在此，我简要总结这段历史，并提供一个治疗伴有精神症状的PD患者的总体方案。
