Psychiatria pre prax 2/2011

Dopamine agonist induced psychosis in Parkinson´s disease

Parkinson´s disease (PD) is severe neurodegenerative disease, which is manifested in addition to motor symptoms with a wide range of non-motor symptoms, including psychotic decompensation. Psychosis associated with Parkinson´s disease is significantly related to treatment of disease, particularly with use of dopamine agonist´s with psychotogenic potential. These drugs stimulate and senzitize mesolimbic dopamine system, which can lead to psychosis in combination with other neuropathological changes in PD. It´s solution accompany serious neuropsychiatric dilemmas in therapy adjustments, as the balance in motor impairment and improvements in psychotic symptomps is very fragile. The authors present a clinical case that illustrates such therapeutic decision-making. Reduction of pramipexole and addition of quetiapin led within eight days to a successful compensation of psychotic patient with PD.

Keywords: Parkinson´s disease, psychosis, pramipexole, clozapine, quetiapine.