Examples of cholinesterase inhibitors include Aricept (donepezil), Exelon (revastigmine), and Razadyne (galantamine). Nuplazid (pimavanserin) is the first drug approved to treat hallucinations and delusions associated with psychosis experienced with Parkinson’s disease dementia.
10 ways to respond when someone is experiencing dementia hallucinations
Olanzapine, amisulpride, ziprasidone, and quetiapine are equally effective against hallucinations, but haloperidol may be slightly inferior. If the drug of first choice provides inadequate improvement, it is probably best to switch medication after 2–4 weeks of treatment.
Remain calm, and try to help the person:
A comforting touch, such as gently patting their back, may help the person turn their attention to you and reduce the hallucination, according to the Alzheimer’s Association. You also can suggest that they move to a different room or take a walk to get away from whatever may have triggered the experience.
Dementia is the most common cause of visual hallucinations in older adults,10 and they can occur with dementia of any etiology. The most common cause of dementia is Alzheimer’s disease, and approximately 18% of patients with Alzheimer’s disease experience visual hallucinations.
Examples of medicines sometimes used to treat hallucinations, paranoia, and severe agitation in people who have dementia include aripiprazole, haloperidol, and risperidone.
The U.S. Food and Drug Administration today approved Nuplazid (pimavanserin) tablets, the first drug approved to treat hallucinations and delusions associated with psychosis experienced by some people with Parkinson’s disease.
When a patient presents with vivid visual hallucinations, a doctor probably considers common diagnoses such as delirium, dementia, psychoses, or a drug related condition. Charles Bonnet syndrome, however, is a condition characterised by visual hallucinations alongside deteriorating vision, usually in elderly people.
There are many causes of hallucinations, including: Being drunk or high, or coming down from such drugs like marijuana, LSD, cocaine (including crack), PCP, amphetamines, heroin, ketamine, and alcohol. Delirium or dementia (visual hallucinations are most common)
If there is no underlying medical condition, changes to lifestyle may lessen the frequency of hallucinations. Getting enough sleep and avoiding drugs and alcohol can reduce their frequency. If hypnagogic hallucinations cause disrupted sleep or anxiety, a doctor might prescribe medication.
Hallucinations are caused by changes in the brain which, if they occur at all, usually happen in the middle or later stages of the dementia journey. Hallucinations are more common in dementia with Lewy bodies and Parkinson’s dementia but they can also occur in Alzheimer’s and other types of dementia.
However, the documented prevalence rates of hallucinations in older adults vary between 0.4 and 37%. For example, Turvey et al. (2001) report 20%, Cole et al. (2002) report 2.5%, Lyketsos et al.
Dehydration occurs when the body does not have enough water and this can happen rapidly in extreme heat or through exercise. Symptoms of dehydration can include headaches, lethargy and hallucinations. In extreme cases, dehydration may result in death.
Medication. Various prescription medicines can occasionally cause hallucinations. Elderly people may be at particular risk. Hallucinations caused by medication can be dose-related and they usually stop when you stop taking the medicine.