Behavioral effects of levodopa.
Identifieur interne : 001997 ( Ncbi/Checkpoint ); précédent : 001996; suivant : 001998Behavioral effects of levodopa.
Auteurs : Isabelle Beaulieu-Boire [Canada] ; Anthony E. LangSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2015.
English descriptors
- KwdEn :
- Animals, Antiparkinson Agents (adverse effects), Behavioral Symptoms (chemically induced), Behavioral Symptoms (therapy), Deep Brain Stimulation, Disruptive, Impulse Control, and Conduct Disorders (chemically induced), Disruptive, Impulse Control, and Conduct Disorders (therapy), Humans, Levodopa (adverse effects), Parkinson Disease (drug therapy).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemically induced : Behavioral Symptoms, Disruptive, Impulse Control, and Conduct Disorders.
- drug therapy : Parkinson Disease.
- therapy : Behavioral Symptoms, Disruptive, Impulse Control, and Conduct Disorders.
- Animals, Deep Brain Stimulation, Humans.
Abstract
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.
DOI: 10.1002/mds.26121
PubMed: 25491470
Affiliations:
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pubmed:25491470Le document en format XML
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<front><div type="abstract" xml:lang="en">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.</div>
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