Coping with Hallucinations from Parkinson's Disease

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A hallucination occurs when someone perceives—sees, hears, feels, smells or tastes—something that is not really there. About 20% of people living with Parkinson’s disease will experience hallucinations, and the risk increases as patients age.

Visual hallucinations are the most common among people who have Parkinson’s disease, although they aren’t always caused by the disease itself. Many times, Parkinson’s hallucinations are a side effect of certain medications treating the disease or sometimes a symptom of an infection. A person with Parkinson’s disease may be less disturbed by the hallucinations than their loved ones are, but it is important to talk with a doctor to find ways to manage hallucinations.

What Hallucinations Are (and Aren’t)

Hallucinations can be the perception of anything—a sound or a touch, for example—that doesn’t actually exist; but hallucinations associated with Parkinson’s disease are most often visual. A person who experiences a Parkinson’s-related hallucination may see a person or animal that isn’t there. Slightly different are illusions, which are the distortion of reality (similar to a mirage) rather than something that is only in the imagination.

Delusions are different from hallucinations, although they are also common among people living with Parkinson’s disease. Delusions occur when someone believes something that isn’t true, despite evidence that the belief is false. For example, a man with Parkinson’s may say he has to go to work at a job he doesn’t have. Hallucinations and delusions are both included in the neuropsychiatric symptoms of Parkinson’s psychosis.

While Parkinson’s psychosis may sound frightening, the visual hallucinations are often neutral or even pleasant, rather than scary. Many times, they are recurring, often of non-threatening people or animals. While much less common, auditory hallucinations may cause a person to hear a radio playing or muffled voices coming from another room. Tactile hallucinations are uncommon; they may feel like an annoying bug crawling on the person. Hallucinations related to smell and taste are rare in people with Parkinson’s.

Risk Factors for Parkinson’s Hallucinations

Not much is known about what causes hallucinations with Parkinson’s disease. Because people living with Parkinson’s disease also are at risk of vision impairment, these problems may contribute to the occurrence of hallucinations. Older people and those with advanced stages of Parkinson’s also tend to have a higher risk of hallucinations.

Hallucinations can be a side effect of a medication or caused by an infection. In these cases, the hallucinations are related to Parkinson’s but not caused by the disease itself.

What to Do About Parkinson’s Hallucinations

Hallucinations or other signs of Parkinson’s psychosis should be discussed with a doctor. Depending on the cause and severity of hallucinations, the person may or may not need treatment. If an infection is the cause, it should be treated accordingly. A doctor may want to change or reduce the dosage of any medications that could cause hallucinations to stop Parkinson’s psychosis.

In mild cases of hallucinations, the person may be aware that the images are not real. In these cases, if the hallucinations are not causing any distress, pharmaceutical treatment may not be necessary. Sometimes improved lighting in darkened or shadowy areas may help reduce occurrences.

Sometimes the person may not realize he or she is hallucinating. In these cases, especially if the hallucinations are severe and disturbing, a doctor may recommend adjustments to the person’s current Parkinson’s medications. However, this could potentially worsen movement-related Parkinson’s symptoms. If these symptoms affect the person’s quality of life, a doctor may instead recommend antipsychotic drugs, particularly clozapine or quetiapine, which typically help reduce hallucinations without affecting other Parkinson’s symptoms.

Other Symptoms of Parkinson’s Disease

There are numerous Parkinson’s disease symptoms, some related to movement and some unrelated. In addition to hallucinations and delusions, people may experience other non-motor symptoms, such as poor sleep and vision problems, which often contribute to the development of hallucinations.

Other non-motor Parkinson’s disease symptoms include:

 
Some motor-related symptoms of Parkinson’s disease include:

  • Tremors of the hands, feet or legs, typically starting on one side of the body, but often occurring, eventually, on both sides

  • Body stiffness

  • Walking, posture and balance problems

  • Voice and talking problems

 
Many of these symptoms are also common with other illnesses. If you or a loved one are experiencing these symptoms, talk with your doctor about the possible causes. In cases when Parkinson’s has already been diagnosed and hallucinations or delusions become troubling, speak with your specialist about how to manage these symptoms as part of a full Parkinson’s treatment plan.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Mar 29
  1. Hallucinations and Delusions in Parkinson’s Disease. Parkinson’s Foundation. https://parkinson.org/blog/research/Hallucinations-and-Delusions-in-Parkinsons-Disease
  2. Hallucinations/Delusions. Parkinson’s Foundation. https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Non-Movement-Symptoms/Hallucinations-Delusions
  3. A Guide for Understanding Parkinson’s Disease Psychosis Hallucinations & Delusions. American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/symptoms/psychosis/
  4. Multisensory Hallucinations and Delusions in Parkinson’s Disease. International Parkinson and Movement Disorder Society. https://www.movementdisorders.org/MDS/Scientific-Issues-Committee-Blog-Multisensory-Hallucinations-and-Delusions-in-Parkinsons-Disease.htm
  5. Psychosis: A Mind Guide to Parkinson’s Disease. Parkinson’s Foundation. https://f5h3y5n7.stackpathcdn.com/sites/default/files/attachments/Psychosis.pdf
  6. Hallucinations and delusions. European Parkinson’s Disease Association. https://www.epda.eu.com/about-parkinsons/symptoms/non-motor-symptoms/hallucinations-and-delusions/
  7. Hallucinations and delusions. Parkinson's Disease Society of the United Kingdom. https://www.parkinsons.org.uk/information-and-support/hallucinations-and-delusions-side-effect
  8. Common Symptoms of Parkinson’s Disease. American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/symptoms/


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