Treatment-Related Psychiatric Complications

Some PD drug therapies are associated with psychiatric side effects, including:

• Mood fluctuations, in a similar manner to motor fluctuations
• Obsessive-compulsive disorder, punding
• Sinemet "addiction" - also referred to as hedonistic homeostatic dysregulation.
• Impulsive-compulsive spectrum disorders can be induced by PD drug treatment or deep brain stimulation (DBS). These can include compulsive/pathologic gambling, shopping, eating, and hypersexual behaviors.
• Observed psychosis is almost always drug-induced in idiopathic PD but can be spontaneous in dementia with Lewy bodies. Symptoms include hallucinations (any modality, usually visual) and delusions, and have been found in 40% of PD cases.