Psychosis

Document Type

Article

Abstract

PURPOSE OF REVIEW: Psychosis can manifest in primary psychotic disorders, neurologic diseases, and medical conditions. This article reviews the definition of psychotic symptoms and the evaluation and management of psychosis in primary psychiatric and neurologic disorders frequently seen in neurologic practice. RECENT FINDINGS: Emerging evidence supports significant connections between psychosis and structural and functional brain changes in both primary psychotic and neurologic disorders. In addition to antidopaminergic activity, the mechanism of new-generation antipsychotics shifts to act on serotonin receptors, which potentially contributes to their benefits in the treatment of negative symptoms of psychosis and a lesser frequency of extrapyramidal side effects compared with typical antipsychotics. This is also helpful in the treatment of psychosis in patients who have neurodegenerative diseases and are vulnerable to developing extrapyramidal side effects from typical antipsychotics. SUMMARY: Even with significant overlap, management of psychosis in primary psychotic disorders differs from the approach of psychosis in neurologic diseases. This article helps clinicians learn how to practically evaluate psychosis from both psychiatric and neurologic perspectives.

Medical Subject Headings

Antipsychotic Agents (therapeutic use); Humans; Psychotic Disorders (diagnosis, drug therapy)

Publication Date

12-1-2021

Publication Title

Continuum (Minneapolis, Minn.)

E-ISSN

1538-6899

Volume

27

Issue

6

First Page

1682

Last Page

1711

PubMed ID

34881732

Digital Object Identifier (DOI)

10.1212/CON.0000000000001013

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