{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:56:42Z","timestamp":1790524602030,"version":"4.1.0"},"reference-count":44,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,11,22]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Non-motor symptoms of Parkinson\u2019s disease (PD) drive disability, reduce quality of life and increase healthcare resource use. Yet, they are often under-recognised in time-limited clinics. We outline an evidence-informed approach for everyday neurology. We propose brief previsit process followed by in-visit prioritisation of one or two high-impact symptoms and simple education\/resources for the rest. Psychosis requires clinicians to address triggers, simplify dopaminergic therapy and use PD-safe antipsychotics when required. Mood and anxiety benefit from optimised dopaminergic regimens, selective serotonin reuptake inhibitors\/serotonin-norepinephrine reuptake inhibitors, counselling, exercise and online cognitive-behavioural programmes. Cognitive impairment warrants regular screening and medication review; cholinesterase inhibitors are indicated for dementia. Sleep management includes treating contributing factors, hygiene measures and cautious hypnotic use. Pain and autonomic dysfunction require pragmatic, stepwise strategies tailored to real-world practice. We include special considerations for atypical Parkinsonism and caregiver needs. Integrating these steps into routine visits improves safety, function and patient\u2013carer well-being.<\/jats:p>","DOI":"10.1136\/pn-2025-004696","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T06:00:16Z","timestamp":1765432816000},"page":"456-463","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Non-motor symptoms in Parkinson\u2019s disease: a practical approach"],"prefix":"10.1136","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1552-1485","authenticated-orcid":false,"given":"Ann","family":"Subota","sequence":"first","affiliation":[{"name":"Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Bruno","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"},{"name":"University of Calgary Hotchkiss Brain Institute, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"2026092100401136000_26.5.456.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01429-0"},{"key":"2026092100401136000_26.5.456.2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1080\/14737175.2021.1883428","article-title":"Non-motor complications in late stage Parkinson\u2019s disease: recognition, management and unmet needs","volume":"21","author":"Rukavina","year":"2021","journal-title":"Expert Rev Neurother"},{"key":"2026092100401136000_26.5.456.3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1468-1331.2008.02212.x","article-title":"Quantitation of non-motor symptoms in Parkinson\u2019s disease","volume":"15 Suppl 2","author":"Chaudhuri","year":"2008","journal-title":"Eur J Neurol"},{"key":"2026092100401136000_26.5.456.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-005-0072-6"},{"key":"2026092100401136000_26.5.456.5","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27602"},{"key":"2026092100401136000_26.5.456.6","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"2026092100401136000_26.5.456.7","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20844"},{"key":"2026092100401136000_26.5.456.8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14802\/jmd.24227","article-title":"Non-Motor Fluctuations in Parkinson\u2019s Disease: Underdiagnosed Yet Important","volume":"18","author":"Boura","year":"2025","journal-title":"J Mov Disord"},{"key":"2026092100401136000_26.5.456.9","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/S0140-6736(99)00860-0","article-title":"Clozapine in drug-induced psychosis in Parkinson\u2019s disease. 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