Schizophrenia and Parkinson's disease: challenges in management

Gadit, Amin A. Muhammad

doi:10.1136/bcr.11.2011.5108

Cited by 9 publications

(14 citation statements)

References 5 publications

(5 reference statements)

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“…[ 10 ] Available data from few of the previous case reports, which had used single-photon emission computed tomography using dopamine transporter (DAT) tracer suggest a significant bilateral decrease of striatal DAT uptake in patients with IPD. [ 1 2 17 ] Patients of AIP will have additional increased nigral signal extension. Thereby, these findings further support the notion that nigrostriatal and mesolimbic dopaminergic pathways largely function independently.…”

Section: Discussionmentioning

confidence: 99%

“…Thereby, these findings further support the notion that nigrostriatal and mesolimbic dopaminergic pathways largely function independently. [ 1 2 10 18 ]…”

Section: Discussionmentioning

confidence: 99%

“…There are limited data on the management of cases with comorbid schizophrenia and IPD [ Table 1 ]. [ 1 2 3 4 5 6 7 8 10 23 24 25 ]…”

Section: Discussionmentioning

confidence: 99%

“…Available literature on comorbidity of idiopathic Parkinson's disease (IPD) and schizophrenia is limited to only a handful of case reports. [ 1 2 3 4 5 6 7 8 ] This possibly suggests that this comorbidity is less common. This could be due to the completely opposite pathophysiology for these disorders, i.e., according to dopamine hypothesis of schizophrenia, positive symptoms are as a result of hyperdopaminergic transmission in the mesolimbic pathway of brain[ 9 ] and symptoms of IPD are as a result of hypodopaminergic transmission in the substantia nigra of the brain.…”

Section: Introductionmentioning

confidence: 99%

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Schizophrenia with Comorbid Idiopathic Parkinson's Disease: A Difficult Clinical Management Scenario

Grover¹,

Sahoo²,

Goyal

2017

Indian Journal of Psychological Medicine

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Comorbidity of idiopathic Parkinson's disease (IPD) and schizophrenia is an uncommon and rare scenario, which often poses a difficult and challenging situation for management. Both the disorders have completely opposite pathophysiology and treatment of one disorder with available pharmacological agents can pose a threat to the other disorder. The situation becomes graver and risk of adverse side effects increases when an individual presents at a later age with both these disorders along with compromised physical and mental health. Of all the available psychopharmacological agents, clozapine has been found to be quite helpful for the management of psychosis without deterioration of existing movement problems of Parkinson's disease. In this case report, we present the case of a 60-year-old female with long-standing paranoid schizophrenia for the last 30 years, who later developed IPD and discuss the various management issues encountered during her treatment.

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Section: Discussionmentioning

confidence: 99%

“…Thereby, these findings further support the notion that nigrostriatal and mesolimbic dopaminergic pathways largely function independently. [ 1 2 10 18 ]…”

Section: Discussionmentioning

confidence: 99%

“…There are limited data on the management of cases with comorbid schizophrenia and IPD [ Table 1 ]. [ 1 2 3 4 5 6 7 8 10 23 24 25 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Schizophrenia with Comorbid Idiopathic Parkinson's Disease: A Difficult Clinical Management Scenario

Grover¹,

Sahoo²,

Goyal

2017

Indian Journal of Psychological Medicine

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“…In fact, treatment with most antipsychotics, mostly dopamine antagonists, leads to parkinsonian side-effects termed as extra pyramidal symptoms. Hence, it does not come as a surprise that only a few case reports mention the coexistence of schizophrenia and idiopathic Parkinson’s disease (3)-(6).…”

mentioning

confidence: 99%

Idiopathic Parkinson’s Disease and Schizophrenia: Dilemma in Diagnosis and Treatment of a Case

Sharma

Aggarwal

2019

IJPS

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The relationship between schizophrenia and idiopathic Parkinson’s disease is still not clear and rare when they coexist. Diagnosing coexisting schizophrenia and idiopathic Parkinson’s disease is a chal-lenge, especially in developing countries due to lack of experts and advance imaging facilities. Treatment options are also limited. A 58- year- old male was admitted due to relapse of psychotic symptoms following non-compliance to antipsychotic medications. The patient was previously diag-nosed with schizophrenia and later developed Parkinson’s disease while non-compliant to antipsy-chotic medications. While the patient was at our center, his detailed history was taken and general physical examination was done to distinguish Parkinson’s disease from anti-psychotic induced ex-trapyramidal symptoms. All the routine investigations were within normal limits. This case report highlights the clinical factors that help make a distinction and help use appropriate drugs to manage schizophrenia with comorbid Parkinson’s disease in developing countries, where lack of precise di-agnostic imaging modalities interferes in making a conclusive diagnosis.

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Increased Risk of Parkinson's Disease in Patients With Schizophrenia Spectrum Disorders

et al. 2021

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A BS TRACT: Background: PD comorbid with schizophrenia has been considered rare because these diseases associate with opposite alterations in the brain dopamine system. The objective of this study was to investigate the risk of PD after a diagnosis of a schizophrenia spectrum disorder. Methods: Regionally, this was a retrospective recordbased case-control study. The cohort included 3045 PD patients treated 2004-2019 in southwestern Finland. Nationally this was a nested case-control study using registers to examine Finnish patients who received a clinically confirmed PD diagnosis 1996PD diagnosis -2015. PD patients with previously diagnosed schizophrenia spectrum disorder (separate analysis for schizophrenia) were included. Comparable non-PD control groups were derived from both data sets. All PD diagnoses were based on individual clinical examinations by certified neurologists. Results: In PD patients, the prevalence of earlier schizophrenia spectrum disorder was 0.76% in regional data and 1.50% in nationwide data. In age-matched controls, the prevalence in the regional and national data was 0.16% and 1.31%, respectively. The odds ratio for PD after schizophrenia spectrum disorder diagnosis was 4.63 (95% CI, 1.76-12.19; P < 0.01) in the regional data and 1.17 (95% CI, 1.04-1.31; P < 0.01) in the national data. Conclusions:Schizophrenia spectrum disorder increases the risk of PD later in life. This association was observed in both individual patient data and nationwide register data. Therefore, despite the opposite dopaminergic disease mechanisms, schizophrenia spectrum disorder increases rather than decreases the risk of PD. The increased PD risk could be related to riskaltering effects of dopamine receptor antagonists or to the increased vulnerability of the dopamine system induced by illness phase-dependent dopamine dysregulation in schizophrenia/schizophrenia spectrum disorder.

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Schizophrenia and Parkinson's disease: challenges in management

Cited by 9 publications

References 5 publications

Schizophrenia with Comorbid Idiopathic Parkinson's Disease: A Difficult Clinical Management Scenario

Schizophrenia with Comorbid Idiopathic Parkinson's Disease: A Difficult Clinical Management Scenario

Idiopathic Parkinson’s Disease and Schizophrenia: Dilemma in Diagnosis and Treatment of a Case

Increased Risk of Parkinson's Disease in Patients With Schizophrenia Spectrum Disorders

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