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https://www.parkinsons.org.uk/information-and-support/hallucinations-and-delusions-side-effect

Hallucinations and delusions

Some people with Parkinson’s may experience hallucinations or delusions. They usually happen as a side effect of your Parkinson’s medication. But in some cases they may be a symptom of your Parkinson’s, or another condition, such as dementia.

What are delusions?

Delusions are strongly held thoughts or beliefs that aren’t based on evidence. This can be one of the most difficult experiences to come to terms with, especially if you have delusions about your carer or someone close to you.

Delusions can include:

Paranoia
You may believe you’re the victim of a conspiracy, or that someone is trying to hurt or harm you.

Jealousy
You may feel jealous of someone you love or a close friend.

Extravagance
You may think you’ve got special powers. This could make you act in an unusual or dangerous way.

Will I experience hallucinations and delusions?

Hallucinations and delusions can affect both younger and older people in the earlier stages of the condition, but are more common in people who’ve had Parkinson’s for a long time.

Hallucinations can affect all of your senses. A hallucination is when you see, hear, feel, smell or even taste something that isn’t actually real. 

There are different types of hallucinations:

Auditory hallucinations – hearing things
You may hear sounds or voices that other people cannot hear, such as music or people talking. Or, you could be convinced you’ve heard a familiar sound, such as a door opening or a doorbell ringing.

Tactile hallucinations – sensing things
This is when you think that someone or something is touching you or the space around you, even when nobody is.

Hallucinating smells and tastes
You may be able to smell something, such as smoke, or taste something you haven’t eaten.

Visual hallucinations – seeing things
You may have hallucinations where you see people, particularly relatives, animals or even insects, that aren’t there. 

If you’ve had a visual hallucination, it is likely that you will be able to describe what you have seen in detail. The images may go away quickly or be remembered for a long time.

Illusions
These are a different type of hallucination. If you experience an illusion, you will see real things in a different way from how they look in real life. For example, patterns on carpets and wallpapers may seem like they are moving, or a coat hanging on a door may look like a person.
 

How can hallucinations affect me?

Hallucinations can be quite frightening, especially when you don’t realise that the things you see, hear or feel aren’t actually real. Some people will be aware that they are hallucinating, and some won’t be. 

How hallucinations affect you will depend on how bad your experiences are and how other people around you respond. 

Hallucinations may also affect you more if you have dementia or memory problems.

Some people find their own ways of dealing with their hallucinations, but if you are finding it hard to cope, there are things that can be done to help (see the section What can you do to manage hallucinations and delusions).

Older people are more likely to experience urinary or chest infections, which can cause hallucinations. If you are an older person with Parkinson’s it is important to be aware of this and get medical advice as soon as possible.

delusions?

Why do some people with Parkinson’s experience hallucinations and delusions?

There are many reasons why someone with Parkinson’s may experience hallucinations and delusions.

Parkinson’s medication

Hallucinations and delusions may be a side effect of Parkinson’s medication. But not everyone who takes Parkinson’s drugs will experience them. It depends on the exact type of medication, the dose and the person taking them. Sometimes, the higher the dose of medication, the more chance there is of experiencing hallucinations.

In particular, some people with Parkinson’s can experience hallucinations or delusions when they have an ‘off’ period. This happens when your medication wears off before your next dose.

If you think your hallucinations are linked to your Parkinson’s medication, speak to your GP, specialist or Parkinson’s nurse as soon as possible about adjusting your dose or changing medication. Your pharmacist will also be able to help you.

Memory problems and dementia

Research shows that hallucinations and delusions often happen when someone with Parkinson’s also has problems with memory, thinking problems or dementia.

If you experience hallucinations at an early stage of Parkinson’s, it could be a sign of another medical condition, such as dementia with Lewy bodies.

Eye problems

Eye problems are more common for people with Parkinson’s than those without the condition. Issues with eyesight can often be linked to hallucinations and delusions so speak to your specialist or Parkinson’s nurse to find out about the best way to manage any eye problems.

Bad lighting can also be a cause of hallucinations and delusions so make sure you can see clearly in your home to rule out this issue.

Depression, sleep problems or very severe Parkinson’s movement symptoms have also been linked to hallucinations and delusions.

What can you do to manage hallucinations and delusions?

If you experience hallucinations or delusions, you should see your specialist or Parkinson’s nurse as soon you can to find out how to reduce them and the distress they often cause.

You should also do this if you’ve had hallucinations or delusions before, and they are getting worse. 

Simple blood or urine tests may help to make sure that another problem, such as a fever resulting from a chest or bladder infection, is not causing your hallucinations or delusions.

Talk to your family

It can help them to understand how you are feeling and become more patient so they can help you to manage your hallucinations or delusions. If people around you can understand and support you, this can make you feel less worried.  

If you have carers at home, help them to understand the following:

• What happens when you experience hallucinations or delusions?
• When are they most likely to happen?
• What makes them happen less often and less strongly?
• How can your carers or family members make things easier for you?

Ask about medication

Because the hallucinations and delusions may be caused by Parkinson’s medication, your GP, specialist or Parkinson’s nurse may suggest some changes to your Parkinson’s treatment. They will aim to find the right medication for managing both your hallucinations or delusions and your other Parkinson’s symptoms. 

Your current dose may be reduced, or a certain type of medication may be gradually stopped to help improve these symptoms. If this doesn’t work, then your specialist may suggest that you take medication that can stop hallucinations or delusions from happening. 

Research shows that experiencing hallucinations or delusions can have a big effect on the quality of life of people with Parkinson’s. It can also be very upsetting to carers and can put stress on relationships. 

Sometimes carers and family members can find it hard to cope with hallucinations and delusions. So it is very important to get medical treatment for hallucinations and delusions, or to learn ways of dealing with them when they happen.

If you experience hallucinations and delusions, read more about how you can manage this symptom.