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)

Two patients with long-standing idiopathic Parkinson's disease (PD), without individual or family histories of affective disorders, developed bipolar mood disorders. Both were treated with lithium and clozapine, and one responded favorably. These may be the first reported cases in which mania was treated with clozapine in PD patients.
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PMID:Treatment of organic bipolar mood disorders in Parkinson's disease. 804 42

To study factors associated with different mood disorders in old age, researchers need clear and meaningful definitions. "Major depression" is too broad and heterogeneous a category, and the boundaries of "dysthymia" are ill-defined, yet epidemiologic studies have focused on these disorders. Depressions in old age are commonly associated with medical conditions; prevalence rates of depression in cases of stroke, Parkinson's disease, dementia, and disabilities (all much commoner in old age) range upward from about 20%. Depressions are attributed to both psychological and biological reactions. Mania, too, can be precipitated by cerebral and other medical factors. The proportion of psychiatric inpatients who have depressions with melancholic and/or psychotic features is higher among elderly subjects, and this has been linked with white matter lesions and other brain changes that become commoner in old age. The prognostic relevance of these brain changes, and implications for treatment of mood disorders, require clarification.
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PMID:Epidemiologic questions on mood disorders in old age. 905 16

Depression is a common condition that often responds to a variety of treatment modalities. Concerns about antidepressant medications' safety and efficacy and individuals' lack of response or their problems complying with medication regimens have prompted a resurgence in electroconvulsive therapy (ECT) for specific mental health conditions. Outpatient maintenance ECT, performed under general anesthesia, is a safe, effective follow-up treatment for individuals with major depression who have undergone inpatient ECT. Individuals with bipolar disorders, catatonia, mania, and schizophrenia and those with Parkinson's disease also can benefit from outpatient ECT. Perioperative nursing care for individuals who undergo outpatient ECT is similar to the care provided to patients scheduled for ambulatory surgery. Successful performance of outpatient ECT requires collaboration by skilled perioperative nurses, psychiatrists, anesthesia care providers, affected individuals, and family members.
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PMID:Treatment of depression with outpatient electroconvulsive therapy. 906 Nov 52

Electroconvulsive therapy (ECT) is an efficacious treatment for a variety of neuropsychiatric conditions including major depression, mania, catatonia, Parkinson's disease, and neuroleptic malignant syndrome. However, ECT-induced memory dysfunction complicates the treatment and is a major concern for both patients and providers. We briefly review ECT-induced memory dysfunction and propose a glutamatergic model for it. (Articles examined were retrieved by a Medline search on the terms electroconvulsion and glutamate, with language limited to English.) Specifically, we hypothesize that ECT-induced memory dysfunction results from neuronal insults due to excessive release of excitatory amino acids and activation of their receptors, which produce cation and water flux and reversible oxidative stress. This model offers multiple testable hypotheses; exploring them may help to identify the risk factors for this significant side effect of ECT treatment and may thus yield effective agents for its prevention and treatment.
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PMID:A glutamatergic model of ECT-induced memory dysfunction. 955 49

Mood disorders constitute a significant clinical problem in patients with a wide range of neurodegenerative disorders. This article reviews recent empirical studies examining depression, anxiety, and mania/disinhibition in patients with focal lesions (stroke), primary subcortical degeneration (Parkinson's disease), and primary cortical degeneration (Alzheimer's disease). Although each neuropsychiatric condition has unique clinical correlates, several common themes can be identified and include similarities in prevalence, neuroanatomic substrate, neurochemistry, and treatment response. Depression, for example, is associated with frontal lobe (primarily left hemisphere) dysfunction in stroke, Parkinson's disease, and Alzheimer's disease, whereas mania and dishinhibition are associated with dysfunction of ventral frontal and ventral temporal structures in both stroke and Alzheimer's disease. These similarities across distinctly different neuropathological conditions can provide important validation of fundamental neuroanatomical, as well as possible psychosocial pathways for the development of mood syndromes in neurological disease. The study of neuropsychiatric syndromes represents an important but relatively understudied area of research, that may ultimately help to illuminate the causes and specific treatments of these important clinical disorders.
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PMID:Mood Disorders in Neurodegenerative Diseases. 1032 Apr 30

There are two families of dopamine (DA) receptors, called D1 and D2, respectively. The D1 family consists of D1- and D5-receptor subtypes and the D2 family consists of D2-, D3-, and D4-receptor subtypes. The amino acid sequences of these receptors show that they all belong to a large superfamily of receptors with seven transmembrane domains, which are coupled to their intracellular signal transduction systems by G-proteins. The implications of DA receptors in neuropsychiatry and cardiovascular and renal diseases are discussed. Neuropsychiatry indications include Parkinson's disease, schizophrenia, migraine, drug dependence, mania and depression, and Gilles de la Tourette syndrome. The underlying dysfunction of dopaminergic systems and the potential benefits of dopaminergic therapy in these different indications are critically examined. With respect to the pharmacological treatment of Parkinson's disease, a range of DA agonists are in various stages of preclinical and clinical development. D2-receptor agonist activity is predominant in most effective antiparkinsonian DA agonists. However, in practice, it is difficult to treat patients for several years with DA agonists alone; therapeutic benefit is not sustained. Rather, the use of a combination of DA agonists and levodopa is considered preferable. Reports of the efficacy of DA partial agonists await confirmation, and recent clinical investigations also suggest the potential of D1 receptor agonists as antiparkinson drugs. Regarding migraine pathogenesis, clinical and pharmacological evidence suggests that DA is involved in this disorder. Most prodromal and accompanying symptoms may be related to dopaminergic activation. Several drugs acting on DA receptors are effective in migraine treatment. Furthermore, migraine patients show a higher incidence of dopaminergic symptoms following acute DA agonist administration, when compared with normal controls. In cardiology, the therapeutic benefits of DA agonists are noted in the treatment of heart failure. Low doses of DA are widely used for its specific dopaminergic effects on renal function, which are suggested to be beneficial, and for its alpha- and beta-adrenergic-mediated responses that occur with higher doses. However, studies have been unable to demonstrate that DA can prevent acute renal failure or reduce mortality. It appears that the significant progress that is being made in the molecular understanding of DA receptors will continue to have a tremendous impact in the pharmacological treatment of neuropsychiatric, cardiovascular, and renal diseases.
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PMID:Dopamine receptors--physiological understanding to therapeutic intervention potential. 1059 3

Degenerative diseases of the basal ganglia, such as Huntington's disease (HD), Parkinson's disease, and Wilson's disease, are characterized by motor, cognitive, and psychiatric manifestations. HD, in particular, can be considered a paradigmatic neuropsychiatric disorder that has all three components of the "Triadic Syndromes": dyskinesia, dementia, and depression. The authors examine the phenomenology, prevalence, and management of psychiatric disturbances occurring in diseases of the basal ganglia. They address psychiatric conditions such as depression, mania, psychosis, obsessive-compulsive disorders, aggression, irritability, apathy, sexual disorders, and delirium, discussing subtleties of diagnosis, and making reference to more unusual disorders of the basal ganglia, such as postencephalitic parkinsonism and Fahr's disease.
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PMID:Neuropsychiatry of Huntington's disease and other basal ganglia disorders. 1066 65

We report a case of recurrent manic episodes associated with chronic deep brain stimulation (DBS) targeting globus pallidus (GP) in the treatment of Parkinson's disease (PD). Cardinal PD symptoms and dyskinesia improved with DBS, and neuropsychological testing found improvements in visuospatial measures associated with left DBS and in verbal memory with right DBS when compared to the patient's preoperative baseline. Under conditions of right, left, and bilateral DBS, the patient experienced bouts of mania and hypomania lasting several days at a time. Positron emission tomography (PET) with (15)O-labeled water was performed after his first manic episode under four conditions: no stimulation, right DBS, left DBS, and bilateral DBS. Although no manic switch occurred during the course of the PET study, all three DBS conditions were associated with decreases in regional flow in the left parahippocampus and hippocampus and right mid-cingulate gyrus. Increases in flow in left inferior frontal area, bilateral insula, dorsolateral prefrontal cortex, and cuneus were common to all DBS conditions. GP stimulation in PD may be associated with behavioral and cognitive effects. Distributed blood flow changes observed with pallidal DBS support a role for the pallidum in cognition and affective regulation.
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PMID:The behavioral complications of pallidal stimulation: a case report. 1075 88

Patients with neurologic illness frequently develop secondary mood disorders that are broadly categorized as unipolar or bipolar. Accurate diagnosis is essential because the treatment of unipolar disorders is markedly different from that of bipolar disorders. Aggressive treatment of mood disorders improves quality of life, reduces morbidity and mortality, and may prevent worsening of both psychiatric and neurologic disease. Antidepressants and psychotherapy are both effective for patients suffering from depressive disorders. Choice of antidepressant depends on the patient's particular symptom complex; medication side effects, which may exacerbate the underlying neurologic condition; potential interactions with other drugs; and costs. Bipolar disorder associated with neurologic illness typically requires treatment with mood stabilizers such as lithium, divalproex sodium, carbamazepine, or verapamil. Although psychotherapy in combination with pharmacologic therapy improves the outcome in bipolar illness, psychotherapy alone is not effective for this condition. Electroconvulsive therapy is an effective treatment for both depression and mania. It may have particular usefulness in Parkinson's disease, for which it has been shown to improve the movement disorder itself. Treatment of bipolar disorder, psychotic depression, or refractory depression is complicated and should be referred to a psychiatrist.
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PMID:Mood Disorders in Neurologic Illness. 1109 45

There is a now a substantial body of evidence that suggests the new antipsychotic agent, risperidone, may be safe and effective for treating psychotic, affective or behavioural symptoms associated with various disorders other than schizophrenia, schizophreniform disorder or schizo-affective disorder. These conditions include bipolar disorder, obsessive-compulsive disorder, Tourette's syndrome, dementia, Lewy body disease, mental retardation, Parkinson's disease, idiopathic segmental dystonia and organic catatonia. Although much of the data is anecdotal or in the form of open studies, there is now emerging a small number of well controlled investigations supporting efficacy for mania, dementia, behavioural disturbance in mental retardation and conduct disorder. Conventional antipsychotics have long been used, either in a primary capacity or as an adjunct to treat these disorders; however, they have limited benefit, pose significant risks of extrapyramidal side-effects, and may cause the potentially life-threatening neuroleptic malignant syndrome. In contrast, risperidone at the recommended low doses may be efficacious and pose reduced risk of motor side-effects. This article reviews the evidence that risperidone may be an effective new treatment for disorders other than schizophrenia.
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PMID:Does risperidone have a place in the treatment of nonschizophrenic patients? 1119 55


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