Psychopharmacology for Patients with Parkinson’s Disease and Deep Brain Stimulation: Lessons Learned in an Academic Center

Author(s): Andreea L. Seritan* , Peter Ureste , Tammy Duong , Jill L. Ostrem .

Journal Name: Current Psychopharmacology

Volume 8 , Issue 1 , 2019

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Graphical Abstract:


Background: Deep brain stimulation (DBS) is a modern neuromodulation method used in the treatment of advanced movement disorders such as Parkinson’s disease (PD) and dystonia. Patients with PD may have multiple psychiatric comorbidities, notably anxiety, depression, mania or hypomania, and psychosis. DBS surgery may indirectly alleviate psychiatric symptoms by allowing reduction of dopaminergic medications, or as a result of functional improvement. Patients who are considering DBS for PD often have more advanced disease and may be more vulnerable to perioperative psychiatric decline. Albeit infrequently, increased depression, apathy, irritability, hypomania or mania, and suicidal behavior have been observed after DBS surgery.

Objective: This review aimed to present current evidence and empirical recommendations for the management of the psychiatric symptoms in patients with PD treated with DBS.

Method: Relevant literature was reviewed and synthesized, along with recommendations informed by the authors’ clinical experience in a large, academic DBS center.

Results: Careful evaluation of DBS candidacy, including assessing the risk for perioperative psychiatric decompensation is advised. Maintaining at least eight weeks of psychiatric stability prior to DBS surgery is strongly recommended. Postoperative management can be challenging due to advanced disease, concurrent psychiatric comorbidities, and possible DBS stimulation-related effects on mood and impulse control. Stimulation-induced elevated mood states (mania, hypomania) have started to be recognized as distinct clinical entities, although not included in the current psychiatric nomenclature.

Conclusion: Insufficient evidence-based strategies for managing psychiatric symptoms in PD patients with DBS exist at this time. Further research is necessary to uncover best practices in this complex, expanding field.

Keywords: Deep brain stimulation geriatric, movement disorders, Parkinson's disease, psychopharmacology, stimulation-induced mood elevation, neuromodulation method.

Weaver FM, Follett KA, Stern M, et al. Randomized trial of deep brain stimulation for Parkinson disease: Thirty-six month outcome. Neurology 2012; 79: 55-65.
Gunduz A, Morita H, Rossi PJ, et al. Proceedings of the second annual deep brain stimulation think tank: What’s in the pipeline. Int J Neurosci 2015; 125: 475-85.
Schüpbach WMM, Chabardes S, Matthies C, et al. Directional leads for deep brain stimulation: Opportunities and challenges. Mov Disord 2017; 32: 1371-5.
Taylor J, Anderson WS, Brandt J, Mari Z, Pontone G. Neuropsychiatric complications of Parkinson disease treatments: Importance of multidisciplinary care. Am J Geriatr Psychiatry 2016; 24: 1171-80.
Mosley PE, Marsh R. The psychiatric and neuropsychiatric symptoms after subthalamic stimulation for Parkinson’s disease. J Neuropsychiatry Clin Neurosci 2015; 27: 19-26.
Seritan AL, Seritan S. Geriatric psychopharmacology in acute settings. Curr Psychopharmacol 2015; 4: 112-8.
American Psychiatric Association. Diagnostic and statistical manual for mental disorders. 5th ed. Arlington, VA: American Psychiatric Association 2013.
Odekerken V, van Laar T, Staal MJ, et al. Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson’s disease (NSTAPS study): A randomised controlled trial. Lancet Neurol 2013; 12: 37-44.
Lang AE, Houeto J-L, Krack P, et al. Deep brain stimulation: Pre-operative issues. Mov Disord 2006; 21(Suppl. 14): S171-96.
Deuschl G, Herzog J, Kleiner-Fisman G, et al. Deep brain stimulation: Post-operative issues. Mov Disord 2006; 21(Suppl. 14): S219-37.
Witt K, Daniels C, Rieff J, et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: A randomised, multicentre study. Lancet Neurol 2008; 7: 605-14.
Okun MS, Wu SS, Fayad S, et al. Acute and chronic mood and apathy outcomes from a randomized study of unilateral STN and GPi DBS. PLoS One 2014; 9: e114140.
Chaudhuri KR, Healy DG, Schapira AH. National Institute for Clinical Excellence. Non-motor symptoms of Parkinson’s disease: Diagnosis and management. Lancet Neurol 2006; 5: 235-45.
Aarsland D, Marsh L, Schrag A. Neuropsychiatric symptoms in Parkinson’s disease. Mov Disord 2009; 24: 2175-86.
Seritan AL, Ostrem JL. Ages of onset of psychiatric disorders in Parkinson’s disease. Poster presented at the American Association of Geriatric Psychiatry Annual Meeting, Dallas, TX, March 2017.
Witjas T, Kaphan E, Azulay JP, et al. Non-motor fluctuations in Parkinson’s disease: Frequent and disabling. Neurology 2002; 59: 408-13.
Martínez-Fernández R, Schmitt E, Martinez-Martin P, Krack P. The hidden sister of motor fluctuations in Parkinson’s disease: A review on nonmotor fluctuations. Mov Disord 2016; 31: 1080-94.
Daniele A, Albanese A, Contarino MF, et al. Cognitive and behavioural effects of chronic stimulation of the subthalamic nucleus in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 2003; 74: 175-82.
Pillon B, Ardouin C, Damier P, et al. Neuropsychological changes between “off” and “on” STN or GPi stimulation in Parkinson’s disease. Neurology 2000; 55: 411-8.
Higginson C, Fields J, Tröster A. Which symptoms of anxiety diminish after surgical interventions for Parkinson disease? Neuropsychiatry Neuropsychol Behav Neurol 2001; 14: 117-21.
Zibetti M, Pesare M, Cinquepalmi A, et al. Neuro-psychiatric therapy during chronic subthalamic stimulation in Parkinson’s Disease. Parkinsonism Relat Disord 2009; 15: 128-33.
Soulas T, Gurruchaga J-M, Palfi S, Cesaro P, Nguyen J-P, Fénelon G. Attempted and completed suicides after subthalamic nucleus stimulation for Parkinson’s disease. J Neurol Neurosurg Psychiatry 2008; 79: 952-4.
Weintraub D, Duda JE, Carlson K, et al. Suicide ideation and behaviors after STN and GPi DBS surgery for Parkinson’s disease: results from a randomized, controlled trial. J Neurol Neurosurg Psychiatry 2013; 84: 1113-8.
Munhoz RP, Teive HA, Troiano AR, et al. Parkinson’s disease and thyroid dysfunction. Parkinsonism Relat Disord 2004; 10: 381-3.
Santos AF, Rodrigues M, Abreu P, Ferreira C. Reversible parkinsonism and cognitive deficits due to vitamin B12 deficiency. Neurol Sci 2015; 36: 1031-2.
Dobkin RD, Menza M, Allen LA, et al. Cognitive-behavioral therapy for depression in Parkinson’s disease: A randomized, controlled trial. Am J Psychiatry 2011; 168: 1066-74.
Dissanayaka NNW, Pye D, Mitchell LK, et al. Cognitive behavior therapy for anxiety in Parkinson’s disease: Outcomes for patients and caregivers. Clin Gerontol 2017; 40: 159-71.
Fitzpatrick L, Simpson J, Smith A. A qualitative analysis of mindfulness-based cognitive therapy (MBCT) in Parkinson’s disease. Psychol Psychother 2010; 83: 179-92.
Dissanayaka NNW, Idu Jion F, Pachana NA, et al. Mindfulness for motor and nonmotor dysfunctions in Parkinson’s disease. Parkinsons Dis 2016; 2016: 7109052.
Miyasaki JM, Shannon K, Voon V, et al. Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006; 66: 996-1002.
Zesiewicz TA, Sullivan KL, Arnulf I, et al. Practice parameter: Treatment of nonmotor symptoms of Parkinson disease: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010; 74: 924-31.
Connolly B, Fox SH. Treatment of cognitive, psychiatric, and affective disorders associated with Parkinson’s disease. Neurotherapeutics 2014; 11: 78-91.
Leo R. Movement disorders associated with the selective serotonin reuptake inhibitors. J Clin Psychiatry 1996; 57: 449-54.
Hawthorne JM, Caley CF. Extrapyramidal reactions associated with serotonergic antidepressants. Ann Pharmacother 2015; 49: 1136-52.
Madhusoodanan S, Alexeenko L, Sanders R, Brenner R. Extrapyramidal symptoms associated with antidepressants- a review of the literature and an analysis of spontaneous reports. Ann Clin Psychiatry 2010; 22: 148-56.
US Food and Drug Administration FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses. [Accessed November 19, 2017]. Available at. DrugSafety/ucm297391.html
Marangell LB, Martinez JM. Concise guide to psychopharmacology. 2nd ed. Washington, DC: American Psychiatric Press, Inc. 2006.
Pies RW. Handbook of essential psychopharmacology. Washington, DC: American Psychiatric Press, Inc. 1998.
Onofrj M, Luciano AL, Thomas A, Iacono D, D’Andreamatteo G. Mirtazapine induces REM sleep behavior disorder (RBD) in parkinsonism. Neurology 2003; 60: 113-5.
Rocha FL, Murad MG, Stumpf BP, Hara C, Fuzikawa C. Antidepressants for depression in Parkinson’s disease: Systematic review and meta-analysis. J Psychopharmacol 2013; 27: 417-23.
Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis. Lancet Neurol 2015; 14: 162-73.
Schroeck JL, Ford J, Conway EL, et al. Review of safety and efficacy of sleep medicines in older adults. Clin Ther 2016; 38: 2340-72.
Mottram P, Wilson K, Strobl J. Antidepressants for depressed elderly. Cochrane Database Syst Rev 2006; 1: CD003491.
Jacobson SA, Pies RW, Greenblatt DJ. Anxiolytic and sedative-hypnotic medications.In: Handbook of geriatric psychopharmacology. Washington, DC: American Psychiatric Publishing, Inc. 2002.
American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2015; 63: 2227-46.
Kassie GM, Nguyen TA, Kalisch Ellett LM, Pratt NL, Roughead EE. Preoperative medication use and postoperative delirium: A systematic review. BMC Geriatr 2017; 17: 298.
Djamshidian A, Friedman JH. Anxiety and depression in Parkinson’s disease. Curr Treat Options Neurol 2014; 16: 285.
Amara A, Chahine L, Videnovic A. Treatment of sleep dysfunction in Parkinson’s disease. Curr Treat Options Neurol 2017; 19: 26.
Aurora RN, Zak RS, Maganti RK, et al. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med 2010; 6: 85-95.
Jung Y, St. Louis EK. Treatment of REM sleep behavior disorder. Curr Treat Options Neurol 2016; 18: 50.
Bonifati V, Fabrizio E, Cipriani R, et al. Buspirone in levodopa-induced dyskinesias. Clin Neuropharmacol 1994; 17: 73-82.
Ludwig C, Weinberger D, Bruno M, et al. Buspirone, Parkinson’s disease, and the locus ceruleus. Clin Neuropharmacol 1986; 9: 373-8.
Van Blercom N, Lasa A, Verger K, et al. Effects of gabapentin on the motor response to levodopa: A double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease. Clin Neuropharmacol 2004; 27: 124-8.
Chana P, de Marinis A, Barrientos N. Gabapentin and motor fluctuations in Parkinson’s disease. Mov Disord 1997; 12: 608.
Olson WL, Gruenthal M, Mueller M, et al. Gabapentin for parkinsonism: A double-blind placebo-controlled, crossover trial. Am J Med 1997; 102: 60-6.
Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the national comorbidity survey replication. Arch Gen Psychiatry 2007; 64: 543-52.
Delle Chiaie R, Minichino A, Salviati M, et al. Bipolar spectrum disorders in patients with cerebellar lesions: A comparison with Parkinson’s disease. J Nerv Ment Dis 2015; 203: 725-9.
Maier F, Merkl J, Ellereit AL, et al. Hypomania and mania related to dopamine replacement therapy in Parkinson’s disease. Parkinsonism Relat Disord 2014; 20: 421-7.
Giovannoni G, O’Sullivan J, Turner K, Manson A, Lees A. Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000; 68: 423-8.
Kim E, Zwil AS, McAllister TW, Glosser DS, Stern M, Hurtig H. Treatment of organic bipolar mood disorders in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1994; 6: 181-4.
Gupta S, Chohan M, Madhusoodanan S. Treatment of acute mania with aripiprazole in an older adult with noted improvement in coexisting Parkinson’s disease. Prim Care Companion J Clin Psychiatry 2004; 6: 50-1.
Schilbach L, Weiss PH, Kuhn J, Timmermann L, Klösterkotter J, Huff W. Pharmacological treatment of deep brain stimulation-induced hypomania leads to clinical remission while preserving motor benefits. Neurocase 2012; 18: 152-9.
Frank E, Kupfer DJ, Thase ME, et al. Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry 2005; 62: 996-1004.
Warren N, O’Gorman C, Lehn A, Siskind D. Dopamine dysregulation syndrome in Parkinson’s disease: A systematic review of published cases. J Neurol Neurosurg Psychiatry 2017; 88: 1060-4.
Weintraub D, Claassen DO. Impulse control and related disorders in Parkinson’s disease. Int Rev Neurobiol 2017; 133: 679-717.
Ducharme S, Flaherty AW, Seiner SJ, Dougherty DD, Morales OG. Temporary interruption of deep brain stimulation for Parkinson’s disease during outpatient electroconvulsive therapy for major depression: A novel treatment strategy. J Neuropsychiatry Clin Neurosci 2011; 23: 194-7.
Vila-Rodriguez F, McGirr A, Tham J, Hadjipavlou G, Honey CR. Electroconvulsive therapy in patients with deep brain stimulators. J ECT 2014; 30: e16-8.
Temel Y, Kessels A, Tan S, Topdag A, Boon P, Visser-Vandewalle V. Behavioural changes after bilateral subthalamic stimulation in advanced Parkinson disease: A systematic review. Parkinsonism Relat Disord 2006; 12: 265-72.
Schneider F, Reske M, Finkelmeyer A, et al. Predicting acute affective symptoms after deep brain stimulation surgery in Parkinson’s disease. Stereotact Funct Neurosurg 2010; 88: 367-73.
Kulisevsky J, Berthier ML, Gironell A, Pascual-Sedano B, Molet J, Parés P. Mania following deep brain stimulation for Parkinson’s disease. Neurology 2002; 59: 1421-4.
Ulla M, Thobois S, Lemaire J-J, et al. Manic behavior induced by deep-brain stimulation in Parkinson’s disease: Evidence of substantia nigra implication? J Neurol Neurosurg Psychiatry 2006; 77: 1363-6.
Raucher-Chéné D, Charrel CL, de Maindreville AD, Limosin F. Manic episode with psychotic symptoms in a patient with Parkinson’s disease treated by subthalamic nucleus stimulation: Improvement on switching the target. J Neurol Sci 2008; 273: 116-7.
Ulla M, Thobois M, Llorca P-M, et al. Contact dependent reproducible hypomania induced by deep brain stimulation in Parkinson’s disease: Clinical, anatomical and functional imaging study. J Neurol Neurosurg Psychiatry 2011; 82: 607-14.
Chopra A, Tye S, Lee KH, et al. Voltage-dependent mania after subthalamic nucleus deep brain stimulation in Parkinson’s disease: A case report. Biol Psychiatry 2011; 70: e5-7.
Chopra A, Tye S, Lee KH, et al. Underlying neurobiology and clinical correlates of mania status after subthalamic nucleus deep brain stimulation in Parkinson’s disease: A review of the literature. J Neuropsychiatry Clin Neurosci 2012; 24: 102-10.
Miyawaki E, Perlmutter JS, Tröster AI, Videen TO, Koller WC. The behavioral complications of pallidal stimulation: A case report. Brain Cogn 2000; 42: 417-34.
Okun MS, Bakay RA, DeLong MR, Vitek JL. Transient manic behavior after pallidotomy. Brain Cogn 2003; 52: 281-3.
Volkmann J, Chabardes S, Steinke GK, Carcieri S. 375 DIRECT DBS: A prospective, multicenter clinical trial with blinding for a directional deep brain stimulation lead. Neurosurgery 2016; 63(Suppl. 1): 211-2.
Wu X, Qiu Y, Simfukwe K, Wang J, Chen J, Hu X. Programming for stimulation-induced transient nonmotor psychiatric symptoms after bilateral subthalamic nucleus deep brain stimulation for Parkinson’s disease. Parkinsons Dis 2017; 2017: 2615619.
Zadikoff C, Munhoz RC, Asante AN, et al. Movement disorders in patients taking anticonvulsants. J Neurol Neurosurg Psychiatry 2007; 78: 147-51.
Athauda D, Batley R, Ellis C. Clinically silent idiopathic Parkinson’s disease unmasked by valproate use: A brief report. Aging Clin Exp Res 2015; 27: 387-90.
Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disord 2016; 4: 27.
Marras C, Herrmann N, Fisher HD, et al. Lithium use in older adults is associated with increased prescribing of Parkinson medications. Am J Geriatr Psychiatry 2016; 24: 301-9.
Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: Updated systematic review and meta-analysis. BMJ 2013; 346: f3646.
Murru A, Popovic D, Pacchiarotti I, et al. Management of adverse effects of mood stabilizers. Curr Psychiatry Rep 2015; 17: 603.
Wang JW, Zhang YQ, Zhang XH, Wang YP, Li JP, Li YJ. Cognitive and psychiatric effects of STN versus GPi deep brain stimulation in Parkinson’s disease: A meta-analysis of randomized controlled trials. PLoS One 2016; 11: e0156721.
Rosa AR, Fountoulakis K, Siamouli M, Gonda X, Vieta E. Is anticonvulsant treatment of mania a class effect? Data from randomized clinical trials. CNS Neurosci Ther 2011; 17: 167-77.
Stanford MS, Anderson NE, Lake SL, Baldridge RM. Pharmacologic treatment of impulsive aggression with antiepileptic drugs. Curr Treat Options Neurol 2009; 11: 383-90.
Berlin HA, Braun A, Simeon D, et al. A double-blind, placebo-controlled trial of topiramate for pathological gambling. World J Biol Psychiatry 2013; 14: 121-8.
Gallagher D, Herrmann N. Antiepileptic drugs for the treatment of agitation and aggression in dementia: Do they have a place in therapy? Drugs 2014; 74: 1747-55.
Yadav R, Pinto C. Mania in Parkinson’s disease with emergent dyskinesia: A case report. Indian J Psychiatry 2000; 42: 439-41.
Sriram A, Ward HE, Hassan A, et al. Valproate as a treatment for dopamine dysregulation syndrome (DDS) in Parkinson’s disease. J Neurol 2013; 260: 521-7.
Hicks CW, Pandya MM, Itin I, Fernandez HH. Valproate for the treatment of medication-induced impulse-control disorders in three patients with Parkinson’s disease. Parkinsonism Relat Disord 2011; 17: 379-81.
Fleisher AS, Truran D, Mai JT, et al. Chronic divalproex sodium use and brain atrophy in Alzheimer’s disease. Neurology 2011; 77: 1263-71.
Reid JG, Gitlin MJ, Altshuler LJ. Lamotrigine in psychiatric disorders. J Clin Psychiatry 2013; 74: 675-84.
Goetz CG, Vogel C, Tanner CM, Stebbins GT. Early dopaminergic drug-induced hallucinations in parkinsonian patients. Neurology 1998; 51: 811-4.
Fénelon G, Mahieux C, Huon R, Ziégler M. Hallucinations in Parkinson’s disease: prevalence, phenomenology, and risk factors. Brain 2000; 123: 733-45.
Fénelon G, Alves G. Epidemiology of psychosis in Parkinson’s disease. J Neurol Sci 2010; 289: 12-7.
Chang A, Fox SH. Psychosis in Parkinson’s disease: Epidemiology, pathophysiology, and management. Drugs 2016; 76: 1093-8.
Lee AH, Weintraub D. Psychosis in Parkinson’s disease without dementia: Common and comorbid with other non-motor symptoms. Mov Disord 2012; 27: 858-63.
Zonana J, Zimmerman M, McCarty SS, Ferrando S. A case of abrupt-onset apathy, psychosis, and depression following deep brain stimulation in a patient with Parkinson’s disease. Psychosomatics 2011; 52: 463-7.
Qureshi A, Cheng JJ, Sunshine AN, et al. Postoperative symptoms of psychosis after deep brain stimulation in patients with Parkinson’s disease. Neurosurg Focus 2015; 38: E5.
National Institute for Health and Care Excellence. Parkinson’s disease in adults. NICE guideline. [Accessed December 6, 2017]. Available at. guidance/ng71
Fujimoto K. Management of non-motor complications in Parkinson’s disease. J Neurol 2009; 256(Suppl. 3): S299-305.
Zahodne LB, Fernandez HH. Parkinson’s psychosis. Curr Treat Options Neurol 2010; 12: 200-11.
Eng ML, Welty TE. Management of hallucinations and psychosis in Parkinson’s disease. Am J Geriatr Pharmacother 2010; 8: 316-30.
Fernandez HH, Trieschmann ME, Friedman JH. Treatment of psychosis in Parkinson’s disease: Safety considerations. Drug Saf 2003; 26: 643-59.
Gomide L, Kummer A, Cardoso F, Teixeira AL. Use of clozapine in Brazilian patients with Parkinson’s disease. Arq Neuropsiquiatr 2008; 66: 611-4.
Weintraub D, Hurtig H. Presentation and management of psychosis in Parkinson’s disease and dementia with Lewy bodies. Am J Psychiatry 2007; 164: 1491-8.
Cummings J, Isaacson S, Mills R, et al. Pimavanserin for patients with Parkinson’s disease psychosis: A randomised, placebo-controlled phase 3 trial. Lancet 2014; 383: 533-40.
Friedman JH, Berman RM, Goetz CG, et al. Open-label flexible-dose pilot study to evaluate the safety and tolerability of aripiprazole in patients with psychosis associated with Parkinson’s disease. Mov Disord 2006; 21: 2078-81.
Pintor L, Valldeoriola F, Baillés E, Martí MJ, Muñiz A, Tolosa E. Ziprasidone versus clozapine in the treatment of psychotic symptoms in Parkinson disease: A randomized open clinical trial. Clin Neuropharmacol 2012; 35: 61-6.
Maust DT, Kim HM, Seyfried LS, et al. Antipsychotics, other psychotropics, and the risk of death in patients with dementia: number needed to harm. JAMA Psychiatry 2015; 72: 438-45.
Pimavanserin (nuplazid) label. [Accessed December 3, 2017]. Available at: drugsatfda_docs/label/2016/207318lbl.pdf
Leroi I, Brandt J, Reich SG, et al. Randomized placebo-controlled trial of donepezil in cognitive impairment in Parkinson’s disease. Int J Geriatr Psychiatry 2004; 19: 1-8.
Ravina B, Putt M, Siderowf A, et al. Donepezil for dementia in Parkinson’s disease: A randomised, double blind, placebo controlled, crossover study. J Neurol Neurosurg Psychiatry 2005; 76: 934-9.
Aarsland D, Hutchinson M, Larsen JP. Cognitive, psychiatric and motor response to galantamine in Parkinson’s disease with dementia. Int J Geriatr Psychiatry 2003; 18: 937-41.
Litvinenko IV, Odinak MM, Mogil’naya VI, Emelin AY. Efficacy and safety of galantamine (reminyl) for dementia in patients with Parkinson’s disease (an open controlled trial). Neurosci Behav Physiol 2008; 38: 937-45.
Emre M, Aarsland D, Albanese A, et al. Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med 2004; 351: 2509-18.
Burn D, Emre M, McKeith I, et al. Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson’s disease. Mov Disord 2006; 21: 1899-907.
Fabbrini G, Barbanti P, Aurilia C, Pauletti C, Lenzi GL, Meco G. Donepezil in the treatment of hallucinations and delusions in Parkinson’s disease. Neurol Sci 2002; 23: 41-3.
Sawada H, Oeda T. Protocol for a randomised controlled trial: Efficacy of donepezil against psychosis in Parkinson’s disease (EDAP). BMJ Open 2013; 3: e003533.
Exelon patch label. [Accessed December 9, 2017]. Available at: label/2015/022083s020lbl.pdf
Leroi I, Overshott R, Byrne E, Daniel E, Burns A. Randomized controlled trial of memantine in dementia associated with Parkinson’s disease. Mov Disord 2009; 24: 1217-21.
Riederer P, Lange KW, Kornhuber J, Danielczyk W. Pharmacotoxic psychosis after memantine in Parkinson’s disease. Lancet 1991; 338: 1022-3.
Voon V, Lang AE. Antidepressants in the treatment of psychosis with comorbid depression in Parkinson disease. Clin Neuropharmacol 2004; 27: 90-2.
Fujimoto K, Sayama S, Shizuma N, Ikeguchi K, Nakano I. Mianserin therapy for psychosis in parkinsonism. Neurol Med 2000; 53: 274-81.
Tagai K, Nagata T, Shinagawa S, Tsuno N, Ozone M, Nakayama K. Mirtazapine improves visual hallucinations in Parkinson’s disease: A case report. Psychogeriatrics 2013; 13: 103-7.
Godschalx-Dekker JA, Siegers HP. Reduction of parkinsonism and psychosis with mirtazapine: A case report. Pharmacopsychiatry 2014; 47: 81-3.
Etminan M, Sodhi M, Samii A, Procyshyn RM, Guo M, Carleton BC. Risk of gambling disorder and impulse control disorder with aripiprazole, pramipexole, and ropinirole: a pharmacoepidemiologic study. J Clin Psychopharmacol 2017; 37: 102-4.
FDA Drug Safety Communication. FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Maintena, Aristada). [Accessed February 5, 2018]. Available at. https://www.
Samuel M, Rodriguez-Oroz M, Antonini A, et al. Management of impulse control disorders in Parkinson’s disease: Controversies and future approaches. Mov Disord 2015; 30: 150-9.
Frank M, Samanta J, Moustafa A, Sherman S. Hold your horses: Impulsivity, deep brain stimulation, and medication in parkinsonism. Science 2007; 318: 1309-12.
Yip SW, Potenza MN. Treatment of gambling disorders. Curr Treat Options Psychiatry 2014; 1: 189-203.

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Year: 2019
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DOI: 10.2174/2211556007666180328142953
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