People With Early Parkinson's Report Hallucinations, Sleepiness

"By identifying risk factors, it may help guide treatment decisions, allow for early intervention and possibly reduce disability," said study author Kevin Biglan, MD, MPH, with University of Rochester School of Medicine in Rochester, NY, and member of the American Academy of Neurology.

For the study, researchers reviewed the results of a four-year clinical trial involving 301 people with an average age of 61 who had early Parkinson's disease. Half of the group received the drug levodopa; the other half took pramipexole. No one reported having hallucinations at the beginning of the study.

The study found nearly one-fifth developed hallucinations, more than one-third of the participants developed sleepiness, and nearly half developed swelling within four years of starting treatment. Multiple health problems, along with age, gender, initial type of treatment and cognitive status were identified as risk factors.

"In contrast to other studies, we found being male, having multiple health problems and taking pramipexole were independently associated with developing sleepiness," said Biglan. "This is the first time a patient's other health problems have been identified as a risk factor for drowsiness."

The study also found being older, having more multiple health problems and the presence of slight memory problems were associated with an increased risk of hallucinations; type of treatment did not affect the risk.

Being female, having heart disease and pramipexole treatment was associated with an increased risk of swelling.

"Our results suggest that other illnesses are important, yet overlooked risk factors for the development of sleep problems, swelling, and hallucinations in early Parkinson's disease and should be considered when talking to patients about the risks of treatment," said Biglan. "When beginning pramipexole, doctors should explain the risks and monitor patients closely for sleep issues and swelling."