The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report
Introduction We present the case of an 82-year-old patient who was treated by our liaison psychiatry unit after a suicide attempt through prescription-drug overdose. The patient had been diagnosed with Parkinson’s disease (PD) ten years prior to his admittance and was being treated with carbidopa/...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821006714/type/journal_article |
| _version_ | 1827754984433778688 |
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| author | A. Cerame Del Campo P. Coucheiro Limeres A. Franco Soler |
| author_facet | A. Cerame Del Campo P. Coucheiro Limeres A. Franco Soler |
| author_sort | A. Cerame Del Campo |
| collection | DOAJ |
| description |
Introduction
We present the case of an 82-year-old patient who was treated by our liaison psychiatry unit after a suicide attempt through prescription-drug overdose. The patient had been diagnosed with Parkinson’s disease (PD) ten years prior to his admittance and was being treated with carbidopa/levodopa and non-ergot dopamine agonists.
Objectives
Impulse control disorders and depression are the most prevalent neuropsychiatric manifestation of PD. According to several sources, this symptomatology is underdiagnosed and undertreated, causing helplessness and distress to patients and their caregivers. Likewise, the accumulated evidence suggests that certain drugs can contribute to the appearance of the aforementioned symptoms.
Methods
A case report is presented alongside a review of the relevant literature regarding the neuropsychiatric manifestations in the context of PD and the diagnosis and treatment of these symptoms.
Results
During his treatment, ropinirole was removed while quetiapine was progressively administered (up to 150mg/day). Carbidopa/levodopa regime was increased causing visual hallucinations and delusional jealousy. A careful balance between antiparkinsonian and antipsychotic medication needed to be achieved before discharge.
Conclusions
Neuropsychiatric manifestations in the context of PD are more prevalent than what was thought in the past. Certain medications, particularly non-ergot dopamine agonists could potentially contribute to the onset of these symptoms. Moreover, these manifestations can be underdiagnosed due to the stigma or social burden imposed upon family and / or caregivers. It is important that recent advances in the understanding of non-motor symptomatology of PD could permeate clinical practice to achieve an adequate identification and treatment of these symptoms.
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| first_indexed | 2024-03-11T07:58:10Z |
| format | Article |
| id | doaj.art-de4a1678b25e4062a33731222c71e87d |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:58:10Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-de4a1678b25e4062a33731222c71e87d2023-11-17T05:05:17ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S250S25010.1192/j.eurpsy.2021.671The challenge of neuropsychiatric manifestations in parkinson’s disease. A case reportA. Cerame Del Campo0P. Coucheiro Limeres1A. Franco Soler2Centro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, SpainCentro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, SpainCentro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, Spain Introduction We present the case of an 82-year-old patient who was treated by our liaison psychiatry unit after a suicide attempt through prescription-drug overdose. The patient had been diagnosed with Parkinson’s disease (PD) ten years prior to his admittance and was being treated with carbidopa/levodopa and non-ergot dopamine agonists. Objectives Impulse control disorders and depression are the most prevalent neuropsychiatric manifestation of PD. According to several sources, this symptomatology is underdiagnosed and undertreated, causing helplessness and distress to patients and their caregivers. Likewise, the accumulated evidence suggests that certain drugs can contribute to the appearance of the aforementioned symptoms. Methods A case report is presented alongside a review of the relevant literature regarding the neuropsychiatric manifestations in the context of PD and the diagnosis and treatment of these symptoms. Results During his treatment, ropinirole was removed while quetiapine was progressively administered (up to 150mg/day). Carbidopa/levodopa regime was increased causing visual hallucinations and delusional jealousy. A careful balance between antiparkinsonian and antipsychotic medication needed to be achieved before discharge. Conclusions Neuropsychiatric manifestations in the context of PD are more prevalent than what was thought in the past. Certain medications, particularly non-ergot dopamine agonists could potentially contribute to the onset of these symptoms. Moreover, these manifestations can be underdiagnosed due to the stigma or social burden imposed upon family and / or caregivers. It is important that recent advances in the understanding of non-motor symptomatology of PD could permeate clinical practice to achieve an adequate identification and treatment of these symptoms. https://www.cambridge.org/core/product/identifier/S0924933821006714/type/journal_articleparkinson’s diseasemanagementneuropsychiatric manifestations |
| spellingShingle | A. Cerame Del Campo P. Coucheiro Limeres A. Franco Soler The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report European Psychiatry parkinson’s disease management neuropsychiatric manifestations |
| title | The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report |
| title_full | The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report |
| title_fullStr | The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report |
| title_full_unstemmed | The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report |
| title_short | The challenge of neuropsychiatric manifestations in parkinson’s disease. A case report |
| title_sort | challenge of neuropsychiatric manifestations in parkinson s disease a case report |
| topic | parkinson’s disease management neuropsychiatric manifestations |
| url | https://www.cambridge.org/core/product/identifier/S0924933821006714/type/journal_article |
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