Good Rx Available!! Dopamine meds for physical parkinsonism: Azilect (mao-b selective inhibitor) & sinemet +/- Comtan (stalevo (carbidopa and levodopa and entacapone) is both together). Tailor rx watching for side effects. Avoid Dopamine agonists (requip xl/mirapex er/neupro)--too side effect prone for lewy body patients. For dementia: namenda, paired with Exelon patch or aricept. For psychosis: seroquel or even clozaril. For excess sleepiness: nuvigil.
Yes. Lewy body dementia (dlb) does have psychotic symptoms, particularly hallucinations. In fact, these are a hallmark feature of dlb. Insight is typically poor. Unlike patients with alzheimer's or parkinson's dementia, patients with dlb exhibit hallucinations early in the course of the illness. Delusions are also common in dlb. Hallucinations go along with poorer daily functioning in these patients.
Common. Visual hallucinations (vh) are a very common symptom in lewy body dementia (lbd). Also common in lbd are: fluctuations in level of arousal or orientation, and, symptoms of parkinsonism (slowed movements, tremor, or shuffling gait). Important to recognize that vh can also have other causes, including ocular problems (e.g. Cataracts) or a side effect of medications.
Yes, very commonly. Neurodegenerative d/o featuring milder physical parkinsonism than parkinson's disease typically. (slowed movements, stiff/rigid muscles & posture, possibly resting tremor). But with early dementia, often with associated psychosis (visual hallucinations, delusional thoughts), excessive sleepiness, depression/anxiety/apathy, & rbd. Rbd = rem behavior d/o, causing acting-out of dreams in rem sleep.