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)

Striatal dopamine receptors were studied in 44 patients with Parkinson disease by the radioligand-binding technique using 3H-spiroperidol. The specific binding of 3H-spiroperidol was either significantly increased or reduced in the caudate nucleus and putamen of parkinsonian patients without levodopa therapy. Scatchard analysis showed that there were corresponding changes in the receptor number, but no significant changes in the mean dissociation constant. The increased binding of 3H-spiroperidol in the basal ganglia was also found in parkinsonian patients suffering from psychotic episodes and treated with neuroleptic drugs. Normal and low binding of 3H-spiroperidol was found in patients treated with levodopa. Clinically, the patients with low binding were more disabled and had lost the beneficial response to levodopa. Thus in Parkinson disease in some patients a denervation supersensitivity seemed to develop and in some others a loss of postsynaptic dopamine receptor sites in the neostriatum. The latter alteration may contribute to the decreased response of parkinsonian patients to chronic levodopa therapy.
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PMID:Dopamine receptors in the Parkinsonian brain. 611 85

Although Parkinson's disease can occur in individuals with psychosis, a patient on antipsychotic medication who develops parkinsonian signs may more readily be diagnosed as and treated for neuroleptic-induced parkinsonism. There are several clinically significant criteria that may aid in proper diagnosis, including clinical course, time and age of onset, nature of tremor, unilaterality of signs, and response to anticholinergic medication. Appropriate diagnosis is essential, as treatment approaches differ for the two disorders. Four case studies are presented to highlight the diagnostic criteria and therapeutic ramifications.
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PMID:Neuroleptic-induced parkinsonism and Parkinson's disease: differential diagnosis and treatment. 613 81

Over a 14-month period in the outpatient department of a geriatric hospital, 7 female patients over 75 years of age were identified with tardive dyskinesia associated with the use of thiethylperazine. The indication for thiethylperazine treatment had been vertigo or dizziness. 3 of the patients also had symptoms related to cerebral arteriosclerosis and 2 had mild Parkinson's disease without levodopa therapy. None of them were markedly demented nor had chronic psychosis. Tardive dyskinesia appeared after a treatment period of 3 weeks to 6 years. These findings suggest that association of tardive dyskinesia with the use of thiethylperazine is not uncommon in geriatric outpatients.
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PMID:Thiethylperazine and tardive dyskinesia. 650 47

L-DOPA has progressively replaced atropinic substances in the treatment of the Parkinson's disease but its superiority is not evident in all domains. The same as these substances, it can occasion a secondary psychical pathology essentially presented by affective disorders and psychotic phenomena. The proposed study lays on the comparison between two parkinsonian groups, one undergoing a dopaminergic treatment the other one not. The hallucinary and confusing properties and to a lesser degree the depressive properties of L-DOPA are correlated to risk factors amongst which the average advanced age of the patients has the greatest place.
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PMID:[Acute psychoses and mood disorders in Parkinson disease. Role of antiparkinson therapy]. 666 15

Exogenous psychotic symptoms of a wide variety have been reported to appear more and more frequently since the introduction of levodopa in the therapy of Parkinson's disease. They were considered to be caused by treatment related imbalance of cerebral neurotransmitters and hypersensitivity of the dopaminergic receptors, respectively. In the present investigation an analysis was done concerning the relevance of different antiparkinsonian drugs and other factors such as severity of neurological and cerebroorganic symptomatology, age, duration of treatment, EEG and brain atrophic changes and additional physical diseases for the appearance of psychotic symptoms. The questions were posed to 152 patients (54 men, 88 women) aged 34-76 years, which received a treatment with levodopa alone, in combination with a decarboxylase inhibitor, amantadines and/or anticholinergics for a period of 1-9 years. An exogenous psychotic symptomatology was observed in 42 patients (27,6%), explicitly under all antiparkinsonistic drugs, but not when amantadines were given as the initial treatment. In patients receiving levodopa/decarboxylase inhibitor psychotic symptoms could be observed most frequently but at the same time the duration of treatment was the longest. In 15 patients psychotic symptoms appeared under different antiparkinsonian drugs. In 28 patients this symptomatology was followed by a constant severe dementia. Predisposing factors for exogenous psychosis proved to be: a higher age at the beginning of the treatment and the initiation of treatment, a pronounced neurological symptomatology and signs of dementia as well as additional physical diseases. Because of the very complex conditions under which exogenous psychosis can be observed and the additional fact that they can appear under each antiparkinsonian substance, levodopa cannot be considered as the sole cause.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Exogenous psychoses in Parkinson syndrome. Frequency and causal conditions]. 674 32

Forty patients with severe Parkinson's disease (23 men, 17 women) who had been treated for six years with L-dopa-decarboxylase inhibitor, were part of a placebo-controlled double-blind trial to test the effectiveness of bromocriptin. In all patients the effectiveness of L-dopa had been decreasing, 34 patients had L-dopa-induced dyskinesias, 35 "on-off" symptoms. Bromocriptin dosage was gradually increased to a total dose of 30 - 40 mg daily. This led to a 25% reduction in L-dopa requirements. The symptoms of Parkinson's disease were favourably influenced, with rigor, tremor and also walking disturbances responding better than bradykinesia of the hands. At the same time, there was a marked prolongation of the periods of good mobility ("on" time) from 7 to 10.8 hours without influence on other "on-off" symptoms such as paradoxical akinesia. Two patients had to be excluded from the trial because the treatment caused side effects (orthostatic hypotension, exogenous psychotic symptoms). Other side effects, such as nausea and mild forms of collapse, could be controlled by drugs.
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PMID:[Bromocriptin in the treatment of progressive stages of Parkinson's disease (author's transl)]. 679 66

Parkinson's disease (P.D.) is characterized by two different types, a benign form found in 85% of patients and a malignant type in 15%. Computer tomography shows malignant patients, in the end stage of the disease process, to exhibit hydrocephalus internus and externus. Such patients exhibit early EEG-deterioration and pharmacotoxic psychosis. The application of neuroleptics to patients with P.D. is associated with an increase in the urinary excretion of acidic metabolites especially of 5-hydroxyindoleacetic acid. It is suggested, that this treatment might also be a useful therapeutic approach to optimizing the residual neuronal function in Parkinson's disease.
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PMID:Benign and malignant types of Parkinson's disease: clinical and patho-physiological characterization. 693 21

Parkinson's disease ranks among the most prevalent neurological diseases in the elderly. The disease usually begins after the age of 50 years, and the risk of the disease rises steeply with advancing age. The primary etiology of Parkinson's disease is still unknown, although the aging process may be an important predisposing factor. There is some overlapping between Parkinson's disease and senile dementia of Alzheimer's type, although both seem to be disease entities. In Parkinson's disease, the most prominent and significant neuropathological change is the progressive loss of substantia nigra dopamine neurons. Studied of striatal dopamine receptors showed that the specific binding of 3H-spiroperidol was either significantly increased or reduced in the caudate nucleus and putamen of parkinsonian patients without levodopa therapy. Scatchard analysis showed that there were corresponding changes in the number of receptors, but no significant changes in the mean dissociation constant. Increased binding of 3H-spiroperidol in the basal ganglia was also found in parkinsonian patients suffering from psychotic episodes and treated with neuroleptic drugs. Normal and low binding of 3H-spiroperidol was found in patients treated with levodopa. The behavior of dopamine receptors in the nucleus accumbens was similar to that of dopamine receptors in the striatum. Clinically, the patients with low binding of 3H-spiroperidol in the striatum were more disabled and had lost the beneficial response to levodopa. Thus in some patients with Parkinson's disease a denervation supersensitivity seemed to develop and in others a loss of postsynaptic dopamine receptor sites in the neostriatum. The latter alteration may contribute to the decreased response of parkinsonian patients to long-term levodopa therapy. However, in patients with a deteriorating response to levodopa, there seem to be still enough dopamine receptors in the striatum for drugs stimulating the dopamine receptors to alleviate directly the parkinsonian disability. Indeed, dopaminergic agonists seem to be a significant and valuable adjuvant therapy to levodopa for parkinsonian patients with a deteriorating response and/or on-off phenomena.
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PMID:Parkinson's disease as a model for changes in dopamine receptor dynamics with aging. 704 3

The pathologic changes of parkinsonism and the side effects of drug therapy may produce pronounced behavioral changes in patients with Parkinson's disease. Dementia is the primary manifestation of disease-induced mental alterations and careful pharmacologic management is necessary. Psychosis is the most dramatic of the changes induced by levodopa. It may occur early in the course of therapy, usually in patients with a past history of a schizophreniform disorder, or after several years of treatment. Therapeutic intervention with dosage adjustments and/or drug holidays are indicated when psychosis occurs. Treatment of depression in the Parkinson patient is essentially the same as in a nonparkinson patient.
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PMID:Behavioral alterations and the therapy of parkinsonism. 711 45

Psychological morbidity is a common consequence of both Parkinson's disease and its treatment with antiparkinsonian agents. The authors describe an unusual case of a patient with Parkinson's disease and a psychosis who was treated with levodopa/carbidopa and very low dose perphenazine. The case raises the issue whether patients with profound psychological reactions to antiparkinson agents may be maintained on antiparkinsonian therapy by the addition of phenothiazines.
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PMID:Low dose perphenazine and levodopa/carbidopa therapy in a patient with Parkinsonism and a psychotic illness. 736 97


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