Electroconvulsive Therapy for Parkinson's Disease with Depression and Neuroleptic Malignant Syndrome: A Case Report

Yuhei Mori; Itaru Miura; Michinari Nozaki; Yusuke Osakabe; Ryuta Izumi; Takahiro Akama; So Kimura; Hirooki Yabe

doi:10.9758/cpn.2021.19.3.572

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자료유형: 학술저널

저자정보: Yuhei Mori (Fukushima Medical University) Itaru Miura (Fukushima Medical University) Michinari Nozaki (Fukushima Medical University) Yusuke Osakabe (Fukushima Medical University) Ryuta Izumi (Fukushima Medical University) Takahiro Akama (Fukushima Medical University) So Kimura (Fukushima Medical University) Hirooki Yabe (Fukushima Medical University)

저널정보: 대한정신약물학회 Clinical Psychopharmacology and Neuroscience Clinical Psychopharmacology and Neuroscience 제19권 제3호

발행연도: 2021.8

수록면: 572 - 575 (4page)

DOI: 10.9758/cpn.2021.19.3.572

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Parkinson’s disease is often complicated by psychiatric symptoms. Psychiatrists are caught in a dilemma between such symptoms and physical treatment since Parkinson’s disease sometimes shows treatment resistance based on pharmacological treatment-induced dopamine dysfunction. Here, we report on a 64-year-old woman with a 15-year history of Parkinson’s disease with stage IV severity based on the Hoehn and Yahr scale. She was admitted to our hospital with a diagnosis of major depressive disorder with psychotic features. Unfortunately, her treatment course for depression was complicated by neuroleptic malignant syndrome. Because we were concerned about the persistence of her depressive symptoms, the risk of psychotropic drugs causing adverse effects, and progressive disuse syndrome, we administered modified electroconvulsive therapy. Her symptoms of neuroleptic malignant syndrome and depression sufficiently improved after five sessions of modified electroconvulsive therapy. Additionally, the primary motor symptoms of her Parkinson’s disease also markedly improved. The improvement of neuroleptic malignant syndrome and her motor symptoms based on dopamine dysfunction can be explained by electroconvulsive therapy’s effectiveness in activating dopamine neurotransmission. Besides, the marked improvement of her depressive episode with psychotic features was presumed to involve dopamine receptor activation and regulation. Because advanced Parkinson’s disease can sometimes be refractory to treatment based on pharmacological treatment-induced dopamine dysfunction, psychiatrists often have difficulty treating psychiatric symptoms; electroconvulsive therapy may stabilize the dopaminergic system in such cases, presenting a possible non-pharmacologic treatment option for Parkinson’s disease.

#Depression #Dopamine #Electroconvulsive therapy #Neuroleptic malignant syndrome #Parkinson disease.

참고문헌 (1)

참고문헌 신청

Amit Singh / 2017 / How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms / Clinical Psychopharmacology and Neuroscience 15(3):210~221

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