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.

 

Contributions:
Reward desensitization in the orbitofrontal cortex: dopamine agonist shift reward system to “addiction” mode.
Hot Topics@SfN 2009
Quentin Barraud, et al.
22 Oct 2009
The neurobehavioral base of pathological gambling remains poorly understood. To date, it has been suggested that pathological gambling occurring in some PD patients could be a consequence of ... 
Failure of ACADIA Pharmaceuticals Pimavanserin Phase III trial for PD Psychosis
A Study of the Safety and Efficacy of Pimavanserin (ACP-103) in Patients With Parkinson's Disease Psychosis
Brian K. Fiske, MJFF
09 Sep 2009
Last week, ACADIA reported initial results from its Phase III efficacy trial for pimavanserin (ACP-103) as a possible treatment for PD psychosis. Results did not meet the primary endpoint ... 
Reward vs. punishment learning is modulated by PD and by dopamine replacement therapy
Reward-learning and the novelty-seeking personality: a between- and within-subjects study of the effects of dopamine agonists on young Parkinson's patients.
Mark Gluck, et al.
05 Aug 2009
Author Dr. Mark Gluck of Rutgers University and Dr. Michael Rogan of MJFF discuss Dr. Gluck's recent paper and the many directions being taken to develop these findings further. ... 
Related Clinical Trials:
Impulse Control Disorders in Parkinson's Patients Treated With Pramipexole and Other Agents (DOMINION Study)
04 Feb 2008
The purpose is to explore the frequency of impulse control disorders in Parkinson's patients treated with different Parkinson's medications. ... 
Acamprosate for Treatment of Compulsive Behaviors and Craving in Parkinson's Disease
27 Dec 2007
The purpose of this study is to determine how many patients with Parkinson's disease have compulsive behaviors, and what types of behaviors they have. This study will also determine if acamprosate ... 
Motor Cortex Reward Signaling in Parkinson Disease
13 Nov 2007
Background: The brain releases signals to mark rewards for certain behavior. Some medications for Parkinson disease (PD) can cause some patients to engage in compulsive behavior, possibly ... 
more
Related Citations:
Mechanisms Underlying Dopamine-Mediated Reward Bias in Compulsive Behaviors
19 Jan 2010
 ... 
Mechanisms Underlying Dopamine-Mediated Reward Bias in Compulsive Behaviors
19 Jan 2010
 ...