1/5. hallucinations, REM sleep, and Parkinson's disease: a medical hypothesis.BACKGROUND: patients with PD can have disabling visual hallucinations associated with dopaminergic therapy. sleep disorders, including vivid dreams and REM sleep with motor behaviors (RBD), are frequent in these patients. methods: The association of hallucinations and REM sleep both at night and during the day was examined in 10 consecutive nondemented patients with long-standing levodopa-responsive PD and hallucinations. Seven patients presented with paranoia and paranoid delusions. Overnight sleep recordings and standard multiple daytime sleep latency test were performed. The results were compared to those of 10 similar patients with PD not experiencing hallucinations. RESULTS: RBD was detected in all 10 patients with hallucinations and in six without. Although nighttime sleep conditions were similar in both groups, hallucinators tended to be sleepier during the day. delusions following nighttime REM period and daytime REM onsets were observed in three and eight of the hallucinators, and zero and two of the others. Daytime hallucinations, coincident with REM sleep intrusions during periods of wakefulness, were reported only by hallucinators. Postmortem examination of the brain of one patient showed numerous lewy bodies in neurons of the subcoeruleus nucleus, a region that is involved in REM sleep control. CONCLUSION: The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery. Psychosis in patients with PD may therefore reflect a narcolepsy-like REM sleep disorder.- - - - - - - - - - ranking = 1keywords = paranoid (Clic here for more details about this article) |
2/5. narcolepsy, paranoid psychosis, and analeptic abuse.Analeptic-induced paranoid psychosis occasionally occurs in the treatment of narcolepsy. Two cases illustrate how analeptic abuse can contribute to the development of paranoid psychosis in narcolepsy and greatly complicate treatment.- - - - - - - - - - ranking = 6keywords = paranoid (Clic here for more details about this article) |
3/5. Pharmacologic and psychotherapeutic issues in coexistent paranoid schizophrenia and narcolepsy: case report.The case of a 32-year-old man with schizophrenia and narcolepsy, two seemingly unrelated disorders, is discussed from the perspective of the diagnostic and therapeutic challenges raised by their coexistence. In addition, the development of tardive dyskinesia and its subsequent amelioration with a depot form of a high-potency neuroleptic are discussed in relation to these disorders. Consistent and supportive psychotherapy for such patients is recommended for maintaining compliance, for pharmacotherapy, and an optimal level of personal, occupational, and interpersonal functioning.- - - - - - - - - - ranking = 4keywords = paranoid (Clic here for more details about this article) |
4/5. narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia.This report describes a man with narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia. The case illustrates the treatment difficulties such a patient presents and also raises questions about interactions between the putative neurotransmitters involved in each of these conditions. It is suggested that the presence of narcolepsy may facilitate the appearance of unwanted effects of antidepressants and neuroleptics such as psychosis and depression.- - - - - - - - - - ranking = 5keywords = paranoid (Clic here for more details about this article) |
5/5. narcolepsy, paranoid psychosis, and tardive dyskinesia: a pharmacological dilemma.The case history of a 54-year-old man with concomitant narcolepsy, paranoid psychosis, and tardive dyskinesia is presented. These disorders may all result from alteration in catecholamines, serotonin, and/or acetylcholine in the central nervous system. The interactions of the various psychopharmacological agents usually used to treat the disorders when they occur separately are considered in terms of current neurotransmitter hypotheses. The management of this case creates a pharmacological dilemma; the agents used for treatment of each of the disorders separately exacerbate one or both of the other two syndromes.- - - - - - - - - - ranking = 5keywords = paranoid (Clic here for more details about this article) |