whopper

Former jolly good fellow
15+ Year Member
Feb 8, 2004
6,947
1,744
Visit site
Status
Attending Physician
OKay

You got a patient with Parkinson's--not enough dopamine in one area of the brain

He's also got psychotic symptoms, too much dopamine in the other part.

So how do you treat this guy?

One of my family practice doctors told me the drug of choice in a situation like this when I was a medstudent but I forgot. Anyone know?
 

Anasazi23

Your Digital Ruler
Moderator Emeritus
10+ Year Member
15+ Year Member
Feb 19, 2003
3,505
26
The innocent shall suffer...big time
Visit site
Status
Attending Physician
Clozaril or an atypical.

Depends though really. Psychotic depression in Parkinson's is treated differently than frank psychosis in a Parkinson's patient. The former may benefit from levodopa or a catechol-O-methyltransferase inhibitors (Comtan).
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,254
3,907
57
Left of Center
Status
Attending Physician
Don't forget about the possibility of Lewy body dementia...
 

mdblue

Senior Member
10+ Year Member
5+ Year Member
2+ Year Member
7+ Year Member
15+ Year Member
Oct 17, 2003
199
1
whopper said:
OKay

You got a patient with Parkinson's--not enough dopamine in one area of the brain

He's also got psychotic symptoms, too much dopamine in the other part.

So how do you treat this guy?

One of my family practice doctors told me the drug of choice in a situation like this when I was a medstudent but I forgot. Anyone know?
1. Clozaril
2. Seroquel
Make sure the psychosis is not drug-induced.