Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bromocriptine is an ergot-derived dopamine agonist. Its current uses include the treatment of Parkinson's disease, postpartum ablaction, prolactinomas, acromegaly, and amenorrhea and galactorrhea secondary to neuroleptic use. It is often reported to produce psychiatric side effects such as confusion, hallucinations, and delusions. The literature is reviewed and supports a strong anecdotal relationship between bromocriptine use and psychosis.
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PMID:Bromocriptine and psychosis: a literature review. 770 Oct 22

We monitored 11 patients with advanced Parkinson's disease (PD) who entered nursing homes over a 5-year period and assessed chronicity of nursing home care, mortality, and hallucinatory status. Two years after the original study's close, none of these patients had ever been discharged from the nursing homes and all were dead. The mortality rate among the nursing home patients was significantly greater than that in 22 community-dwelling subjects with PD who were matched for age, gender, and disease duration. Hallucinatory status was generally stable; 82% of patients had the same hallucinatory status (presence or absence) at the two assessments. Four subjects from the original community-dwelling control group entered nursing homes during the follow-up period. Whereas motor and intellectual impairment scores were similar between these patients and the remaining 18 in the community, the presence of hallucinations was significantly greater among patients transferred to nursing homes. The study demonstrates the permanency of nursing home placement in advanced PD and the high mortality associated with such placement. It also documents the chronicity of hallucinatory behavior in these patients with advanced PD and reinforces our previously reported observations on the relationship between hallucinations and placement in chronic-care facilities.
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PMID:Mortality and hallucinations in nursing home patients with advanced Parkinson's disease. 772 53

We evaluated the effects of mianserin, a relatively selective 5-HT2 receptor antagonist, on symptoms related to drug-induced psychosis in patients with Parkinson's disease (PD). A total of 12 patients with PD who had developed drug-induced psychosis showed delirium (DSM-III-R criteria; n = 10) and pure visual hallucinations (n = 2). The antiparkinsonian drugs involved in the drug-induced psychosis were L-DOPA/carbidopa, bromocriptine, trihexyphenidyl, and amantadine. They received mianserin (mean 36.7 mg, range 20-60 mg) given orally for 8 weeks. Complete relief or marked improvement in psychotic symptoms was noted in 8 patients, moderate improvement in 2 patients, and no effect in 2 patients. The parkinsonian disability also decreased slightly in 8 patients. These results suggest that serotonin antagonism at 5-HT2 receptors may not only play an important role in the treatment of drug-induced psychosis in PD, but may also ameliorate the symptoms of parkinsonism.
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PMID:Mianserin treatment of patients with psychosis induced by antiparkinsonian drugs. 777 16

Psychiatric symptoms were investigated and compared in 95 patients with Alzheimer type dementia (DAT) and in 39 patients with Parkinson's disease with dementia (PD-D). The diagnosis of the dementia and psychiatric disorders was based on DSM III R criteria; dementia stage was assessed using the Clinical Dementia Rating Scale (CDR). PD-D were significantly older than DAT patients. Delirium was more frequent in the advanced stages of both PD-D and DAT, being mainly of the hypoactive type in PD-D and the hyperactive type in DAT. Delusions and hallucinations predominated in the early CDR stages of both illnesses and did not differ between groups; the same was true for depression. The results revealed different psychopathological profiles in DAT and PD-D patients.
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PMID:Differing patterns of psychiatric impairment in Alzheimer and demented parkinsonian patients. 787 58

Delusions and other manifestations of psychotic behavior are common side effects in Parkinson's disease (PD) patients chronically treated with dopaminergic drugs. Clozapine, a dibenzodiazepine derivative, is an antipsychotic drug largely devoid of extrapyramidal side effects. We evaluated the effects of low doses of clozapine on the mental and motor functions in PD patients requiring antipsychotic treatment. Twenty-seven PD patients taking dopaminergic drugs and who had psychotic behavior received clozapine at 12.5 to 75 mg/d. Fifteen patients received clozapine for 1 to 11 months (mean, 6.8 months) and seven received it for 12 to 24 months (mean, 18 months). No patient exhibited motor deterioration, and the psychotic features disappeared immediately, allowing discontinuation of clozapine after several months in 10 patients. Fifteen patients are still receiving clozapine and are free of psychiatric symptoms. The clozapine treatment was discontinued after 5 days (25 mg/d) in two patients because of somnolence. No patient developed neutropenia. Clozapine in low doses is effective in the treatment of drug-induced delusions and hallucinations in PD.
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PMID:Low-dose clozapine in the treatment of levodopa-induced mental disturbances in Parkinson's disease. 789 90

Seventy-four in- and out-patients (mean age 71.9 years) with Parkinsonian syndromes (summarized as "PS": idiopathic Parkinson's disease, vascular pseudo Parkinsonian syndrome (VPS), and Parkinson-dementia (PDK)) were prospectively evaluated as to present clinical state according to usual rating scales, as to clinical syndrome and physician's diagnosis and treatment at the start of the illness, and as to current medical and social care. 54% of the patients had history and findings of tremor, 14% had visual hallucinations, 19% had depression. Ratings on part II of the "Unified Parkinson's Disease Rating Scale" (UPDRS) describing "activities of daily living" correlated highly with the ratings of part III ("motor evaluation") and with another activity of daily living scale according to Schwab and England. The mean difference between time of diagnosis and start symptoms (the "diagnostic delay") was nearly 21 months. Initial symptoms did not show an impact on this difference. 68% of patients were presently treated by general physicians and were significantly older than those treated by neurologists. 59% were in-patients during the study and were more likely to carry a diagnosis of VPS or PDK. 75% of those patients who were ever in-patients during their illness had the disease for up to six years before they were first hospitalized. 77% of the patients had drug treatment; 88% of these took L-Dopa preparations. 23% of patients with drug treatment had L-Dopa-associated motor complications. 15% of patients lived alone, 66% with their family, and 19% in a nursing home. 24% of patients had assistance in their household by a professional caretaker. 16% of patients retired early from work. The long-term care of older Parkinsonian patients is a task for general medicine based on neurogeriatric expertise.
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PMID:[Medical management and social status of elderly Parkinson patients]. 797 17

Apomorphine is a potent dopamine agonist at both D1 and D2 receptors and has been used successfully for treating the 'on/off' phenomenon in Parkinson's disease. We report our experience with apomorphine in treating the 'on/off' phenomenon in L-dopa responsive idiopathic Parkinson's disease. Thirteen such patients were commenced on apomorphine infusions. Their mean age was 69 (range 53-80) years and the mean duration of the disease was 15 (range 6-28) years. The clinical response to apomorphine was good in four patients, fair in two, unchanged in five and worse in two. Activities of daily living improved in six, were unchanged in five and worse in two. When the response was poor or showed no change, apomorphine was discontinued. In addition, apomorphine was also discontinued in three patients who had had a fair/good response but suffered side effects of hallucinations, delusions and psychosis, lack of cooperation or found the pump inconvenient. Apomorphine was continued in only three patients out of 13.
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PMID:Subcutaneous apomorphine infusion in Parkinson's disease: does it have a role? 801 4

A long-term follow-up evaluation on the clinical usefulness of selegiline hydrochloride (selegiline) was performed in 13 patients with Parkinson's disease. All patients, except one case, subjected to the study were symptomatically improved by combination therapy of selegiline with L-DOPA in the preceding short-term evaluation. One patient continued the therapy after an evaluation of no symptomatic improvement in the short-term study, because this patient strongly requested continuation of medication, expecting to stop the progression of the disease. The average daily dose of selegiline at the last evaluation was 6.9 +/- 2.5 mg. The average daily dose of L-DOPA at each evaluation point in the patients who continued the therapy for 12 months remained low compared to that prior to the therapy (before: 450 +/- 117 mg, at the 12th month: 389 +/- 89 mg). In the analysis of individual parkinsonian symptoms, the improvement in the mean score for most of the symptoms, especially the wearing-off phenomenon and frozen gait, persisted for the entire period of study. Global improvement rates (moderately improved) at the 6th and 12th month, and the last evaluation were 61.5%, 44.4% and 46.2%, respectively. Among 13 patients, therapy was discontinued only in one case due to hallucination. Although the global improvement rate declined in the course of the therapy, selegiline seems to be useful for improving L-DOPA responsive symptoms in long-term therapy for Parkinson's disease.
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PMID:[A long-term clinical effect of selegiline hydrochloride on Parkinson's disease]. 806 Jun 85

I have proposed recently that the positive symptoms of schizophrenia such as hallucinations and delusions reflect a compensatory mechanism to overcome the dopaminergic deficiency which underlies the core pathology of the disease, namely the negative syndrome. In such case it is possible, in analogy with Parkinson's disease, that these compensatory mechanisms will diminish with progression of the disease. Thus, one would expect the severity of positive symptoms in schizophrenia to decline with progression of the disease. To test this hypothesis, I studied in 20 chronic schizophrenic patients the association between positive symptoms (hallucinations and delusions) with chronicity of illness. I found a significant inverse correlation between chronicity of illness and severity of delusions (r = -.51, p < .05) and hallucinations (r = -.47, p < 0.05). In contrast, chronicity of illness was unrelated to negative symptoms (blunted affect and emotional withdrawal). These data support the prediction that the compensatory ability of the brain to increase dopamine functions may diminish with progression of the disease and are in accord with the clinical impression that with time schizophrenic patients tend to display a more negative syndrome profile and become "burnt out schizophrenics."
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PMID:Positive symptoms and chronicity of illness in schizophrenia. 808 25

Serotonergic (5-HT) and dopaminergic activities have been examined in Lewy Body Dementia (LBD) and compared with Parkinson's disease (PD) and Alzheimer's disease (AD). In the neocortex the LBD subgroup experiencing hallucinations was distinguished from the other categories by an increase in the 5HIAA:5HT ratio measured in frontal cortex and by the serotonergic (5-HIAA or 5-HIAA:5-HT): cholinergic (choline acetyltransferase) ratio in frontal and temporal cortex. In the neostriatum (caudate nucleus), loss of dopamine and increased HVA:dopamine ratio correlated with the reduction in substantia nigra neurons in LBD but not PD, despite the greater loss of neurones and dopamine and the higher dopamine turnover ratio in PD. LBD patients experiencing severe Parkinsonism as a result of neuroleptic treatment tended to have lower neuron counts, in combination with higher turnover ratios, than the remainder. Qualitative differences between LBD and PD included decreased cortical 5-HT turnover in PD compared with the increase in LBD. There were no significant changes in any parameter in AD, with the exception of a reduction in temporal cortex 5HIAA. The results suggest that although the neurochemical pathology of LBD and PD involves similar systems, the nature of the derangements differs sufficiently between the diseases to account for differences in symptomatology.
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PMID:Monoaminergic activities in Lewy body dementia: relation to hallucinosis and extrapyramidal features. 812 90


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