Neuropsychiatric symptoms are prominent clinical features of dementia with Lewy bodies (DLB). Visual hallucinations have been reported to be particularly common. Auditory hallucinations, delusions, and depression also may be characteristic to DLB. Misidentification delusions may be more common than with other types of delusional syndromes. Supersensitivity to neuroleptic drugs is common, making treatment of these symptoms difficult, and newer, atypical compounds have been recommended. However, supersensitive reactions to these medicines have been reported. Patients with DLB, especially those with visual hallucinations, are reported to have a marked cholinergic deficit, and cholinergic drugs may be beneficial in reducing the neuropsychiatric symptoms.
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