Psychological Medicine

Research Article

Psychiatric symptoms during L-dopa therapy for Parkinson's disease and their relationship to physical disability

R. H. S. Mindhama11, C. D. Marsdena1 and J. D. Parkesa1

a1 Department of Psychiatry, Nottingham University Medical School, Department of Neurology, Institute of Psychiatry, London


Fifty patients attending a neurological outpatient clinic for Parkinson's disease were assessed by standardized methods for both physical and psychiatric symptoms. The patients then received treatment with L-dopa, L-dopa with carbidopa or anticholinergic drugs and/or amantadine. During the following six-month period the subjects were assessed at intervals, both physically and psychiatrically. Forty patients were followed up for the full six-month period. The severity of physical signs and affective symptoms was shown to be significantly related at several stages of the investigation. Initially, the patients showed a high psychiatric morbidity. During treatment, 22 patients developed a depressive disorder, 12 of which had a history of previous depressive episodes. By contrast, of the 11 patients who showed very few affective symptoms during follow-up, none had a history of depression. Of the 22 patients with a depressive disorder, only two were in the anticholinergic/amantadine group, compared with nine and 11 in the other groups. L-dopa was not an effective antidepressant agent. The probable relevance of the findings of the study to the management of patients with Parkinson's disease is outlined.


1 Address for reprints: Dr R. H. S. Mindham, Department of Psychiatry, Mapperly Hospital, Nottingham NG3 6AA.