[Psychic disorders and somnolence].
Hallucinations (mainly visual), psychosis and excessive daytime sleepiness are potential side-effects of dopaminergic treatment. They may require a reduction or suppression of dopaminergic agonists, and the prescription of atypical neuroleptic agents or vigilance-enhancing drugs. The recent description of narcolepsy-like sleep onset in rapid eye movement sleep periods synchronous with hypnagogic hallucinations in patients with dopaminergic-induced psychosis or excessive daytime sleepiness, suggests that the mesodiencephalic lesions may predispose to the psychic effects of dopaminergic treatment. Disease-related mood disorders, sexual compulsions, gambling or levodopa addiction may also be amplified by the antiparkinsonian treatment. These complications illustrate the neuro-psychic aspect of Parkinson's disease: psychic troubles may result from a subtle balance between the direct effects of drugs, the pre-morbid pathological personality and the cortical and subcortical lesions.
Houeto
J L
JL
Fédération de Neurologie, Centre d'Investigation Clinique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Arnulf
I
I
D006970:Disorders of Excessive Somnolence / Q000139:chemically induced*; D004298:Dopamine / Q000009:adverse effects*; D006801:Humans; D001523:Mental Disorders / Q000139:chemically induced*; D010300:Parkinson Disease / Q000188:drug therapy*
D004298:Dopamine
Troubles psychiques et somnolence.