001     273018
005     20250127091655.0
024 7 _ |a pmc:PMC11588934
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024 7 _ |a 10.1007/s00415-024-12576-x
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024 7 _ |a pmid:39046524
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024 7 _ |a 0367-004X
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024 7 _ |a 0012-1037
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024 7 _ |a 0340-5354
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024 7 _ |a 1432-1459
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037 _ _ |a DZNE-2024-01377
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Witt, Karsten
|0 0000-0002-9384-3474
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245 _ _ |a Diagnostics and treatment of impulse control disorders, psychosis and delirium: systemic review-based recommendations - guideline 'Parkinson's disease' of the German Society of Neurology.
260 _ _ |a Heidelberg
|c 2024
|b Springer
336 7 _ |a article
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336 7 _ |a ARTICLE
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520 _ _ |a Impulse control disorders (ICD), psychosis and delirium are part of the spectrum of behavioural changes associated with Parkinson's disease (PD). The diagnostic and therapeutic management of these rather complex neuropsychiatric conditions has been updated in the clinical guideline by the German Society of Neurology (DGN).Recommendations are based on a systematic literature reviews, other relevant guidelines and expert opinion.Patients receiving dopamine agonists (DA) therapy should be informed about the symptoms and risks of an ICD and should be routinely screened for ICD symptoms. In the presence of an ICD, DA should be reduced or discontinued and psychotherapeutic treatment may be considered. Non-oral therapies (levodopa/carbidopa intestinal gel infusion or deep brain stimulation) may also be an option for appropriate candidates. Psychosis in PD often has a gradual onset. Cognitive and affective disorders, psychiatric and medical comorbidities as well as polypharmacy are risk factors for a psychosis. Non-pharmacological treatments should be implemented as soon as possible and anti-parkinsonian medications should be adjusted/reduced if feasible. For psychosis associated with PD, quetiapine or clozapine should be used on an as-needed basis and for as short a time as is necessary, with safety monitoring. Delirium in PD may be underdiagnosed due to an overlap with chronic neuropsychiatric features of PD. Although transient by definition, delirium in PD can lead to permanent cognitive decline, motor impairment and increased mortality. Management of delirium includes pharmacological and non-pharmacological interventions.The updated guideline encompasses the evidence-based diagnostic, non-pharmacological and pharmacological management of ICD, psychosis and delirium in PD.
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650 _ 7 |a Delirium
|2 Other
650 _ 7 |a Guideline
|2 Other
650 _ 7 |a Impulse control disorder
|2 Other
650 _ 7 |a Parkinson’s disease
|2 Other
650 _ 7 |a Psychosis
|2 Other
650 _ 7 |a Antiparkinson Agents
|2 NLM Chemicals
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Psychotic Disorders: therapy
|2 MeSH
650 _ 2 |a Psychotic Disorders: diagnosis
|2 MeSH
650 _ 2 |a Psychotic Disorders: etiology
|2 MeSH
650 _ 2 |a Psychotic Disorders: drug therapy
|2 MeSH
650 _ 2 |a Parkinson Disease: therapy
|2 MeSH
650 _ 2 |a Parkinson Disease: complications
|2 MeSH
650 _ 2 |a Parkinson Disease: diagnosis
|2 MeSH
650 _ 2 |a Delirium: therapy
|2 MeSH
650 _ 2 |a Delirium: diagnosis
|2 MeSH
650 _ 2 |a Delirium: etiology
|2 MeSH
650 _ 2 |a Disruptive, Impulse Control, and Conduct Disorders: etiology
|2 MeSH
650 _ 2 |a Disruptive, Impulse Control, and Conduct Disorders: therapy
|2 MeSH
650 _ 2 |a Disruptive, Impulse Control, and Conduct Disorders: diagnosis
|2 MeSH
650 _ 2 |a Germany
|2 MeSH
650 _ 2 |a Societies, Medical: standards
|2 MeSH
650 _ 2 |a Neurology: standards
|2 MeSH
650 _ 2 |a Practice Guidelines as Topic: standards
|2 MeSH
650 _ 2 |a Antiparkinson Agents: therapeutic use
|2 MeSH
650 _ 2 |a Antiparkinson Agents: administration & dosage
|2 MeSH
700 1 _ |a Levin, Johannes
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773 _ _ |a 10.1007/s00415-024-12576-x
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