Induction of Mania by L-Dopa in a Nonbipolar Patient

Harsch, Harold H.; MILLER, MIKE; Young, Laurens D.

doi:10.1097/00004714-198505060-00006

Cited by 10 publications

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“…Earlier literature, instead, explicitly cited mania or hypomania among the possible complications of PD, addressing caveats 8,9 . Several case reports have indicated the prior occurrence or co‐occurrence of BSDs in PD patients 10‐28 . The 2006 international guidelines on subthalamic nucleus deep brain stimulation (STN‐DBS) 29 in PD, included hypomania as a preoperative concern, and more recent guidelines repeat the concern 30 .…”

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confidence: 99%

“… 8 , 9 Several case reports have indicated the prior occurrence or co‐occurrence of BSDs in PD patients. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 The 2006 international guidelines on subthalamic nucleus deep brain stimulation (STN‐DBS) 29 in PD, included hypomania as a preoperative concern, and more recent guidelines repeat the concern. 30 The disappearance of mania/hypomania from the list of psychiatric complications of PD is likely due to the conceptual reframing of nonmotor aspects of PD and identification of ICDs as a specific psychiatric aspect of PD 7 appearing in patients exposed to dopamine agonist (DA) treatments.…”

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confidence: 99%

“…Following the epidemiological reports, new studies addressed BSDs in PD, generically naming the described disorders as hypomania. 42 , 43 , 44 , 45 Guided by earlier literature, 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 and also because, in several legal instances, two senior authors of the present paper were asked to provide an earnest analysis for compensation claims, which were at the time prevalent on social and public media, 46 , 47 , 48 , 49 we started testing all PD patients in our cohort using psychiatric scales and interviews to assess BSDs. When the last epidemiological studies were published, 35 , 36 we thought we could present our data for discussion.…”

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Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease

et al. 2021

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Background Patients with bipolar spectrum disorders (BSDs) exhibit an increased risk of Parkinson's disease (PD). Objective The aim is to investigate whether a previous diagnosis of BSDs influences the phenotype of PD. Methods Of 2660 PD patients followed for at least 6 years (6–27), 250 (BSD‐PD) had BSDs, 6–20 years before PD diagnosis; 48%–43% had a PD or BSD family history, and 34 carried glucocerebrosidase (GBA) and Parkin (PRKN) mutations. The cohort was split into a subset of 213 BSD‐PD patients, compared with 426 matched PD patients without BSDs, and a subset of 34 BSD‐PD and 79 PD patients carrying GBA or PRKN mutations. Carriers of mutations absent in BSD‐PD patients and of synuclein triplication were excluded. Structured clinical interviews and mood disorder questionnaires assessed BSDs. Linear mixed models evaluated the assessment scales over time. Thirteen BSD‐PD patients underwent subthalamic nucleus deep brain stimulation (STN‐DBS) and were compared with 27 matched STN‐DBS‐treated PD patients. Results Compared to PD patients, BSD‐PD showed (1) higher frequency of family history of PD (odds ratio [OR] 3.31; 2.32–4.71) and BSDs (OR 6.20; 4.11–9.35) 5); (2) higher incidence of impulse control disorders (hazard ratio [HR] 5.95, 3.89–9.09); (3) higher frequency of functional disorders occurring before PD therapy (HR, 5.67, 3.95–8.15); (4) earlier occurrence of delusions or mild dementia (HR, 7.70, 5.55–10.69; HR, 1.43, 1.16–1.75); and (5) earlier mortality (1.48; 1.11–1.97). Genetic BSD‐PD subjects exhibited clinical features indistinguishable from nongenetic BSD‐PD subjects. STN‐DBS‐treated BSD‐PD patients showed no improvements in quality of life compared to the control group. Conclusions BSDs as a prodrome to PD unfavorably shape their course and are associated with detrimental neuropsychiatric features and treatment outcomes. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

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Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease

et al. 2021

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“…Mood elevation was described early on with the use of l ‐dopa. Several cases of new‐onset hypomania or mania or worsening of bipolar disorder occurring during treatment with l ‐dopa have been reported. Hypomania and mania also can occur as part of the DDS, or in the context of non‐motor fluctuations.…”

Section: Hypomania/maniamentioning

confidence: 99%

Behavioral effects of levodopa

Beaulieu‐Boire

Lang

2014

Movement Disorders

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In recent years, levodopa-induced behavioral changes have received increased attention in the medical literature and in clinical practice. The spectrum of these symptoms includes non-motor fluctuations with neuropsychiatric symptoms, compulsive behaviors such as punding, dopamine dysregulation syndrome, and impulse control disorders, psychosis and hallucinations, as well as hypomania and mania. Despite knowledge of the clinical features associated with these behaviors, many of them are probably underdiagnosed. Although the mechanisms underlying behavioral symptoms are still incompletely understood, recent data from imaging and pathological studies have increased our understanding and guided new treatment strategies. Appropriate management remains challenging, because reduction of levodopa (l-dopa) and dopaminergic treatment is often recommended; however, doses required for control of motor symptoms may still induce behavioral changes. Newer modes of delivery of dopaminergic treatment, deep brain stimulation, and nondopaminergic agents may either provide alternatives for treatment of these behavioral problems or permit treatment of parkinsonism with less risk of these behavioral disorders.

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“…Additionally, in our review of the literature we found ten case-stories in nine journal articles [82][83][84][85][86][87][88][89][90]. Some reports deal with manic attacks in PD without relation to drug treatment [82][83][84]86,87], and some deal with probable drug-induced manic attacks in PD patients treated with apomorphine or levodopa [85,88,89]. Only one case story presents a bipolar affective patient who subsequently developed PD.…”

Section: Bipolar Disorder and Pdmentioning

confidence: 99%

Parkinson’s disease and affective disorder: The temporal relationship

Nilsson¹

2012

OJPsych

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In relationship between the affective disorders and Parkinson’s disease (PD) it was found that comorbidity was higher than expected in the majority of the studies. Patients with PD are at increased risk of developing depression and, conversely, recent studies have shown that patients with depressive disorders have increased risk of incident PD. However, the temporal associations between the disorders are not fully elucidated. From this review it could be learned that the temporal aspects strongly suggest that a neurobiological association exists between affective disorder and PD. This is illustrated with hitherto unpublished data. Some of these issues may be investigated in case register studies, e.g. by linkage of registers of somatic and psychiatric illness, and suggestions for future research are given. For GP’s, psychiatrists, geriatricians, and neurologists these new findings will lead to a better understanding and better treatment for patients with complicated comorbid conditions. Here timing is important

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Induction of Mania by L-Dopa in a Nonbipolar Patient

Cited by 10 publications

References 0 publications

Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease

Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease

Behavioral effects of levodopa

Parkinson’s disease and affective disorder: The temporal relationship

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