Introduction/Objectives:
Psychosis in Parkinson's disease can be caused by both extrinsic and intrinsic factors.
Participants, Materials/Methods:
Case presentation: In the period from 1982 to 1986 the patient S.A. (75-year-old woman) had been hospitalized several times. She was admitted to the psychiatry with the diagnosis psychosis depressive and cured with antipsychotics (clozapine, levomepromazin) and antidepressants (maprotilin). In 2009 she was again admitted, but this time in the semistuporous state, mutistic, with the clinical state of paranoid – halucinatory psychosis. She was diagnosed Parkinson's disease 2 years ago and has been treated with the combination of levodopa and benzerazid as well as entekapon.
Results:
The question is whether the trigger for the psychosis is Parkinson's disease, antiparkinsonian medications in itself, or the previous psychiatric diagnosis represents the risk factor which enables the antiparkinsonian medications to activate the psychosis. The treatment involved gradual decrease in the dosage of antiparkinsonian medications and introduction of antipsychotics (clozapine).