title: Levodopa treatment and mood fluctuation in dementia with Lewy bodies: a case report.
abstract: L-3,4-dihydroxyphenylalanine (L-dopa) has been the gold standard for pharmacotherapy for parkinsonism in patients with dementia with Lewy bodies (DLB). While L-dopa treatment is related to visual hallucinations, its relationship to mood fluctuation in DLB is poorly understood. Herein, we report the improvement of behavioural and psychological symptoms of dementia through the adjustment of L-dopa treatment in a 78-year-old woman with probable DLB. Her marked mood swings were improved by changing L-dopa administration from three to five times per day while maintaining the same total daily dosage. This observation suggests that there may be an association between plasmatic L-dopa levels and mood fluctuation in patients with DLB. This pharmacological approach may be useful in the management of behavioural and psychological symptoms of dementia without the use of antipsychotic agents to avoid severe neuroleptic sensitivity, which is one of the suggestive clinical features in the Third Consortium on DLB clinical criteria.
authors.affiliation: PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan; Department of Psychiatry, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Koji
authors.initials: K
authors.lastname: Kasanuki
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000339:Affect / Q000187:drug effects; D000368:Aged; D015897:Comorbidity; D015259:Dopamine Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D020961:Lewy Body Disease / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D019964:Mood Disorders / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D015259:Dopamine Agents; D007980:Levodopa
keywords: BPSD; Parkinson's disease; dementia; dopamine; pharmacotherapy