Research article

Dopamine Agonists and their risk to induce psychotic episodes in Parkinson's disease: a case-control study

Daniel Ecker^1,3, Alexander Unrath¹, Jan Kassubek¹ and Michael Sabolek^1,2*

• * Corresponding author: Michael Sabolek michael.sabolek@uni-greifswald.de

Author Affiliations

¹ Department of Neurology, University of Ulm, 89081 Ulm, Germany

² Current address: Department of Neurology, EMA-University of Greifswald, 17475 Greifswald, Germany

³ Current address: Focus Clinical Drug Development, Neuss, Germany

For all author emails, please log on.

BMC Neurology 2009, 9:23 doi:10.1186/1471-2377-9-23

Published: 10 June 2009

Abstract

Background

Psychosis is rare in untreated patients with Parkinson's disease (PD) but the prevalence rises to 40% during dopaminergic treatment. So far, no systematic comparison of the psychogenic potential of different dopaminergic drugs had been performed.

Methods

Eighty PD patients with psychotic episodes were compared to an age-matched control group of PD patients without psychotic episodes (n = 120) in a cross-sectional retrospective study.

Results

We found a positive correlation between psychotic episodes and dementia, number of concomitant medication, and pergolide intake. Odds ratio calculation confirmed the association with dementia. With respect to dopaminergic treatment, pergolide showed the highest odds ratio, levodopa the lowest. An adjusted logistic regression model confirmed the strong association with psychotic episodes and pergolide and no association with levodopa (adjusted odds ratio 2.01 and 0.11, respectively).

Conclusion

The analysis indicates that dementia and concomitant medication are factors in PD associated with psychotic symptoms. Furthermore, different dopaminergic drugs showed markedly different associations with psychotic symptoms