Pimavanserin is an atypical antipsychotic used to manage Parkinson’s disease psychosis. It acts as a 5-HT2A receptor inverse agonist and antagonist. Unlike other antipsychotics, pimavanserin does not interact with D2 receptors, making it ideal in treating psychosis symptoms while preserving motor function. Pimavanserin has also been shown to cause QTc prolongation. Therefore, patients should be monitored for any new onset palpitations or syncope when starting this medication. Quetiapine and clozapine are other treatment options for Parkinson’s disease psychosis.