The FDA has approved the atypical antipsychotic pimavanserin (Nuplazid – Acadia) for treatment of hallucinations and delusions associated with Parkinson's disease. It is the first drug to be approved in the US for this indication.

PARKINSON'S DISEASE PSYCHOSIS — Hallucinations and delusions occur in up to 60% of patients with Parkinson's disease.1 Low doses of clozapine (Clozaril, and others) have been effective for treatment of these symptoms, but even in low doses clozapine can cause agranulocytosis, somnolence, and other significant toxicity.2,3 Low-dose quetiapine has been used off-label to treat Parkinson's disease psychosis, but it has not been effective in controlled trials.4,5 Both clozapine and quetiapine block dopamine receptors and could exacerbate the motor symptoms ... more      

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