title: Covariation of depressive symptoms, parkinsonism, and post-dexamethasone plasma cortisol levels in a bipolar patient: simultaneous response to ECT and lithium carbonate.
abstract: A patient presented with concurrent mood congruent delusions, parkinsonism, and elevated post-dexamethasone plasma cortisol levels. This triad could result from simultaneous development of cholinergic-monoaminergic dysfunction within critical limbic and extrapyramidal loci. The magnitude of each abnormality decreased in concert during a course of electroconvulsive therapy (ECT). Remaining abnormalities disappeared during treatment with lithium. Actions of ECT and lithium on muscarinic systems are reviewed, and a strategy for testing the hypothesis that dysfunction of cholinergic-monoaminergic mechanisms develops in parallel in different neural networks is considered.
mesh_terms: D001714:Bipolar Disorder / Q000503:physiopathology* / Q000628:therapy; D001921:Brain / Q000503:physiopathology; D003907:Dexamethasone; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008094:Lithium / Q000627:therapeutic use; D016651:Lithium Carbonate; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000502:physiology; D010300:Parkinson Disease / Q000150:complications*
chemical_list: D018377:Neurotransmitter Agents; D016651:Lithium Carbonate; D003907:Dexamethasone; D008094:Lithium; D006854:Hydrocortisone