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Behavioral effects of levodopa
Author(s) -
BeaulieuBoire Isabelle,
Lang Anthony E.
Publication year - 2015
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26121
Subject(s) - levodopa , hypomania , mania , dopaminergic , parkinsonism , psychology , apathy , deep brain stimulation , psychosis , hypersexuality , dopaminergic pathways , psychiatry , neuroscience , impulse control disorder , medicine , dopamine , disease , pathological , bipolar disorder , parkinson's disease , cognition
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. © 2014 International Parkinson and Movement Disorder Society