Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report

Guedes, Bruno Fukelmann; Gonçalves, Mauro; Cury, Rubens Gisbert

doi:10.1590/s1980-5764-2016dn1002011

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Most of these patients developed punding after the introduction or increase of DA and/or levodopa, or with surreptitious intake of levodopa. Treatment‐wise, the reduction or discontinuation of the DA and/or levodopa, the introduction of clozapine or IJL resulted in complete relief or improvement in seven patients (64%) 33–35,38–40 …”

Section: Resultsmentioning

confidence: 99%

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Punding in Parkinson's Disease: An Update

Rajalingam

Fasano

2023

Movement Disord Clin Pract

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Background Punding is a stereotyped behavior characterized by an intense fascination with a complex, excessive, non‐goal oriented, repetitive activity affecting individuals with Parkinson's disease (PD) on dopamine replacement therapy (DRT). Objectives In 2010, we published the first review focused on the pathophysiology of punding. This study aims to systematically review the literature of the past decade on punding in PD, particularly focusing on the clinical features, underlying pathophysiological mechanisms, and treatment. Methods Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, we searched PubMed, Embase, and APA PsycInfo for articles published between July 1, 2010 and March 19, 2022. The search strategy included: (punding) AND (parkinson*). Results Of 256 studies identified, 29 were eligible for inclusion with 19 original research articles and 10 case reports. This review confirmed that predictors of punding in PD are higher doses of DRT, younger age, male sex, and increasing disease severity. We also found an association between punding and psychiatric and/or cognitive symptoms. Neuroimaging studies have showed that punding in PD is associated with a disconnection between midbrain, limbic and white matter tracts projecting to the frontal cortices and a breakdown of the connectivity among the crucial nodes of the reward circuit. Low‐frequency repetitive transcranial magnetic stimulation on the dorsolateral prefrontal cortex has been shown to produce a transient beneficial effect in PD patients with punding. Conclusion In conclusion, although the clinical features of punding have been established, in the past 12 years, we gained a better understanding of the pathophysiological mechanisms of punding, mainly thanks to magnetic resonance imaging techniques.

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Section: Resultsmentioning

confidence: 99%

“…Treatment‐wise, the reduction or discontinuation of the DA and/or levodopa, the introduction of clozapine or IJL resulted in complete relief or improvement in seven patients (64%). 33 , 34 , 35 , 38 , 39 , 40 …”

Section: Resultsmentioning

confidence: 99%

Punding in Parkinson's Disease: An Update

Rajalingam

Fasano

2023

Movement Disord Clin Pract

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“…A presença de psicose na PDP está associada a um aumento na sobrecarga dos cuidadores, maior taxa de institucionalização e maior mortalidade. A psicose, juntamente com outros sintomas não motores da DP, deve ser considerada no manejo adequado dos pacientes, pois alguns relatam que esses sintomas são ainda mais incapacitantes do que os sintomas motores, conforme observado por pacientes e seus cuidadores perturbações, tais como ansiedade, apatia, depressão, alucinações, delírios, irritabilidade e apatia (Bruno Fukelmann Guedes et al, 2016).…”

Section: Introductionunclassified

Eficácia da pimavanserina para pacientes com psicose na doença de Parkinson: Uma revisão sistemática

Mendes,

Souza,

Silva Junior

et al. 2024

RSD

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O presente estudo tem como objetivo avaliar a eficácia da pimavanserina em pacientes com psicose na doença de Parkinson. Foram avaliados seus efeitos no quadro clínico da psicose, assim como suas reações adversas e influências na qualidade de vida dos pacientes. Trata-se de uma Revisão Sistemática da Literatura de natureza qualitativa, com estratégia de busca os Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e avaliação metodológica Critical Appraisal Skill Programme (CASP), analisando-se ao total 8 artigos. Os artigos foram pesquisados nas bases de dados PubMed, excluindo revisões simples de literatura e artigos incompletos. Foram incluídos os publicados nos últimos 10 anos (2013-2023) e disponibilizados em inglês. Após uma análise sistemática dos estudos, conclui-se que a pimavanserina demonstra eficácia na redução dos sintomas alucinógenos e delirantes. Além disso, constatou-se que a combinação da pimavanserina com outros medicamentos, especialmente a clozapina, se mostrou promissora em termos de segurança, principalmente na melhora das funções cognitivas. Os pacientes apresentaram melhorias na qualidade do sono e vigília, além de redução significativa dos sintomas. Ademais, entre os efeitos colaterais estão pneumonia, episódios de síncope, doença pulmonar obstrutiva, embolia pulmonar e trombose venosa profunda. Espera-se que estudos futuros continuem a desenvolver mais pesquisas de intervenção sobre a eficácia da medicação no tratamento da doença de Parkinson, destacando benefícios e melhorias na qualidade de vida dos pacientes através do uso do fármaco na prática médica.

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Management of Impulse Control and Related Disorders in Parkinson's Disease: An Expert Consensus

Debove,

Paschen,

Amstutz

et al. 2024

Movement Disorders

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BackgroundImpulse‐control and related behavioral disorders (ICBDs) significantly impact the lives of Parkinson's disease (PD) patients and caregivers, with lasting consequences if undiagnosed and untreated. While ICBD pathophysiology and risk factors are well‐studied, a standardized severity definition and treatment evidence remain elusive.ObjectiveThis work aimed to establish international expert consensus on ICBD treatment strategies. To comprehensively address diverse treatment availabilities, experts from various continents were included.MethodsFrom 2021 to 2023, global movement disorders specialists engaged in a Delphi process. A core expert group initiated surveys, involving a larger panel in three iterations, leading to refined severity definitions and treatment pathways.ResultsExperts achieved consensus on defining ICBD severity, emphasizing regular PD patient screenings for early detection. General treatment recommendations focused on continuous monitoring, collaboration with significant others, and seeking specialist advice for legal or financial challenges. For mild to severe ICBDs, gradual reduction in dopamine agonists was endorsed, followed by reductions in other PD medications. Second‐line treatment strategies included diverse approaches like reversing the last medication change, cognitive behavior therapy, subthalamic nucleus deep brain stimulation, and specific medications like quetiapine, clozapine, and antidepressants. The panel reached consensus on distinct treatment pathways for punding and dopamine dysregulation syndrome, formulating therapy recommendations. Comprehensive discussions addressed management strategies for the exacerbation of either motor or non‐motor symptoms following the proposed treatments.ConclusionThe consensus offers in‐depth insights into ICBD management, presenting clear severity criteria and expert consensus treatment recommendations. The study highlights the critical need for further research to enhance ICBD management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report

Cited by 3 publications

References 18 publications

Punding in Parkinson's Disease: An Update

Punding in Parkinson's Disease: An Update

Eficácia da pimavanserina para pacientes com psicose na doença de Parkinson: Uma revisão sistemática

Management of Impulse Control and Related Disorders in Parkinson's Disease: An Expert Consensus

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