A 78-year-old man with a 5-year history of Parkinson's disease develops vivid visual hallucinations of animals in his bedroom. He finds them mildly di...

Question

A 78-year-old man with a 5-year history of Parkinson's disease develops vivid visual hallucinations of animals in his bedroom. He finds them mildly distressing but recognises they are not real. He has no delirium. His cognition is preserved (MoCA 25). He is on Co-careldopa 25/100 mg QDS and Pramipexole 1 mg TDS. What is the MOST appropriate medication adjustment?

Accepted Answer

Reduce and withdraw Pramipexole first

Answer

Add Quetiapine 25 mg at night

Answer

Increase Co-careldopa to compensate and stop Pramipexole abruptly

Answer

Start Donepezil for hallucinations

Answer

Add Clozapine immediately

uk-dgm MCQ (SBA): Visual Hallucinations in Parkinson's Disease