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‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon
‘Levodopa Phobia’ is under-recognised in Parkinson’s disease but can cause profound detrimental clinical complications if left to continue. Several types can be encountered in clinical practice and can be driven by a misplaced fear of levodopa-induced dyskinesias, other gastrointestinal side effects...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168519/ https://www.ncbi.nlm.nih.gov/pubmed/30302392 http://dx.doi.org/10.1038/s41531-018-0067-z |
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author | Titova, Nataliya Levin, Oleg Katunina, Elena Ray Chaudhuri, K. |
author_facet | Titova, Nataliya Levin, Oleg Katunina, Elena Ray Chaudhuri, K. |
author_sort | Titova, Nataliya |
collection | PubMed |
description | ‘Levodopa Phobia’ is under-recognised in Parkinson’s disease but can cause profound detrimental clinical complications if left to continue. Several types can be encountered in clinical practice and can be driven by a misplaced fear of levodopa-induced dyskinesias, other gastrointestinal side effects and also the theoretical notion that levodopa may be toxic to dopaminergic neurons in the brain. The condition can be underpinned by a sense of strong influence from the physicians or carers who are unwilling to prescribe or consider levodopa, and also high levels of anxiety or even impulsive compulsive traits in patients who have been influenced by available literature or social media-based information. If unrecognised, the clinical issue may lead to motor deterioration and related muscle contractures leading to social isolation as well as a range of non-motor symptoms. In some, there may be emergence of intrusive impulse control disorders because of reliance on only dopamine agonists related to the fear of taking levodopa. Four cases illustrate the different patterns of ‘Levodopa Phobia’ in this study. Management of levodopa phobia is complex and includes recognition and skilled neuropsychological interventions to break the misperceptions about the complications of levodopa therapy. |
format | Online Article Text |
id | pubmed-6168519 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-61685192018-10-09 ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon Titova, Nataliya Levin, Oleg Katunina, Elena Ray Chaudhuri, K. NPJ Parkinsons Dis Perspective ‘Levodopa Phobia’ is under-recognised in Parkinson’s disease but can cause profound detrimental clinical complications if left to continue. Several types can be encountered in clinical practice and can be driven by a misplaced fear of levodopa-induced dyskinesias, other gastrointestinal side effects and also the theoretical notion that levodopa may be toxic to dopaminergic neurons in the brain. The condition can be underpinned by a sense of strong influence from the physicians or carers who are unwilling to prescribe or consider levodopa, and also high levels of anxiety or even impulsive compulsive traits in patients who have been influenced by available literature or social media-based information. If unrecognised, the clinical issue may lead to motor deterioration and related muscle contractures leading to social isolation as well as a range of non-motor symptoms. In some, there may be emergence of intrusive impulse control disorders because of reliance on only dopamine agonists related to the fear of taking levodopa. Four cases illustrate the different patterns of ‘Levodopa Phobia’ in this study. Management of levodopa phobia is complex and includes recognition and skilled neuropsychological interventions to break the misperceptions about the complications of levodopa therapy. Nature Publishing Group UK 2018-10-02 /pmc/articles/PMC6168519/ /pubmed/30302392 http://dx.doi.org/10.1038/s41531-018-0067-z Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Perspective Titova, Nataliya Levin, Oleg Katunina, Elena Ray Chaudhuri, K. ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title | ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title_full | ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title_fullStr | ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title_full_unstemmed | ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title_short | ‘Levodopa Phobia’: a review of a not uncommon and consequential phenomenon |
title_sort | ‘levodopa phobia’: a review of a not uncommon and consequential phenomenon |
topic | Perspective |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168519/ https://www.ncbi.nlm.nih.gov/pubmed/30302392 http://dx.doi.org/10.1038/s41531-018-0067-z |
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