Impostors and Disguises in the Parkinson's World
Capgras syndrome is the belief that a friend or family member has been replaced by another individual. A person with Parkinson's may worry that a visiting sister is not really her, but an impostor.
A second, less common syndrome, will cause people with Parkinson's to believe a stranger is really a person they know disguised as someone they've never met.
People with Parkinson's-related delusions can also worry that there is something dangerous, suspicious, or highly illegal occurring in their neighborhood. A recent case report in the journal Movement Disorders discussed a man who was certain someone was dealing drugs from his home. He regularly watched for an opportunity to catch the criminals.
Common delusions among people with Parkinson's disease lead them to accuse their spouse of adultery, stealing or otherwise emotionally harming them. Some proclaim that their house or other familiar buildings are replicas. There are reports of people outright rejecting their homes.
How to Handle Delusions in Parkinson's Disease
Helping a person with Parkinson's-related delusions is the responsibility of a neurologist or psychiatrist. When vital chemicals are out of balance, it takes time for doctors to restore a portion of that balance. In some cases it may be best to hospitalize the patient.
Doctors often try to strike a delicate balance between Parkinson's medicines and drugs that address the delusions. It can be difficult because Parkinson's medications often contribute to the delusions. Ironically, many anti psychotic medications also produce delusions in the Parkinsonian mind.
Sometimes the first drug changes do not help a patient. Patients and family members should be patient with their doctor and the situation during this time of trial and error.
Sources:
Journal of Neuropsychiatry, May 1998
Movement Disorders, published online November 28, 2007
