Psychosis and Other Psychiatric Manifestations of Levodopa Therapy

IN RECENT years levodopa has proved to be the most effective agent presently available for the treatment of parkinsonism. 1-6 Among the side effects of levodopa therapy, psychiatric disturbances have been noted. 3-6 Levodopa is not only the precursor of dopamine hydrochloride but also of norepinephrine. 7 Although the action of these two catecholamines upon the central nervous system is incompletely understood, evidence has been accumulated in the last two decades upon their action in behavior. 8,9 In this context we would like to report 16 cases of psychiatric disturbances which occurred among 45 patients treated with levodopa. Method Levodopa was administered to 45 patients (31 men and 14 women) with Parkinson's syndrome. Forty-one patients had primary parkinsonism or Parkinson's disease, three had postencephalitic parkinsonism, and one had arteriosclerotic parkinsonism. Of the patients willing to enter the program, only those with decompensated cardiovascular disease, renal disease, psychosis