Typical antipsychotics, such as haloperidol, and newer agents with dopamine D2 receptor affinity are avoided in the long-term treatment of visual hallucinations and agitation because of potential worsening of motor symptoms, cognitive decline, delirium, and features of neuroleptic malignant syndrome associated with dopamine receptor blockage.1 Amitriptyline is not indicated for psychosis.
1. Fernandez HH, Trieschmann ME, Burke MA, Friedman JH. Quetiapine for psychosis in Parkinsons disease versus dementia with Lewy bodies. J Clin Psychiatry 2002;63:513-5.
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