Hallucinations and dyskinesia with pramipexole in parkinson’s disease-a case report

Pramipexole, a dopamine agonist has a tendency to induce psychotic symptoms, when used to treat Parkinson’s disease (PD). In most of the cases, patient’s psychosis developed after addition of Pramipexole and exacerbated after increasing the dosage. However there has been no case report in which Pramipexole has caused psychosis at lowest starting dose without any add on drug. Here we present a case of PD in which dyskinesia and psychosis appeared with first dose of Pramipexole, as low as 0.125mg. The patient was a 76 year old man with a one year history of PD. One year back patient observed tremors in his hand and slowing of movements. The neurologist prescribed Syndopa plus - 125, Benzhexol (schedule also same as Syndopa) and Pramipexole 0.125 mg at bedtime. The patient decided to start all medicines next day except Pramipexole (125mg) which he took at bed time. Within half an hour, patient started having visual and auditory hallucinations, along with abnormal movements and myoclonic jerks of hand, feet and mouth. He could be seen doing movements as if he is inserting needle in thread. According to him, he could visualize thieves trying to steal his car. Dechallenge with Pramipexole led to complete resolve of psychotic symptoms. After 4 weeks of therapy, there was a gradual but steady improvement in dyskinesia and tremors except slurring in speech

Hallucinations and dyskinesia with pramipexole in parkinson's disease-a case report

Pramipexole, a dopamine agonist has a tendency to induce psychotic symptoms, when used to treat Parkinson’s disease (PD). In most of the cases, patient’s psychosis developed after addition of Pramipexole and exacerbated after increasing the dosage. However there has been no case report in which Pramipexole has caused psychosis at lowest starting dose without any add on drug. Here we present a case of PD in which dyskinesia and psychosis appeared with first dose of Pramipexole, as low as 0.125mg. The patient was a 76 year old man with a one year history of PD. One year back patient observed tremors in his hand and slowing of movements. The neurologist prescribed Syndopa plus - 125, Benzhexol (schedule also same as Syndopa) and Pramipexole 0.125 mg at bedtime. The patient decided to start all medicines next day except Pramipexole (125mg) which he took at bed time. Within half an hour, patient started having visual and auditory hallucinations, along with abnormal movements and myoclonic jerks of hand, feet and mouth. He could be seen doing movements as if he is inserting needle in thread. According to him, he could visualize thieves trying to steal his car. Dechallenge with Pramipexole led to complete resolve of psychotic symptoms. After 4 weeks of therapy, there was a gradual but steady improvement in dyskinesia and tremors except slurring in speech

Effectiveness of cognitive behaviour therapy in combination with savoring in moderate depression

Cognitive behavioural therapy (CBT) is one of the most reliable and proven treatment for patients with various psychological disorders. A significant number of researches revealed that CBT with antidepressants showed significant lower number of relapse than the pharmacotherapy group. However, despite the significant role of efficacy of CBT for depression, its role in order to prevent relapse is not clear. On the other hand, positive psychological intervention has also been instrumental to enhance well-being but there is scarcity of scientific literature regarding the treatment of clinical depression. Therefore, there is a strong need for the development of a combo package of CBT and Positive psychological interventions for the treatment of depression. Keeping this into view, the aim of the present study is to explore the effectiveness of cognitive behaviour therapy in combination with savoring in moderate depression. Methodology: For this purpose, a 4X6 factorial design was made. Here four types of therapies were given to patients with moderate depression like pharmacotherapy, CBT, Composite savoring index and combo package of CBT and Composite savoring index. All these four groups were tested under six phases

Neural Substrate of Group Mental Health: Insights from Multi-Brain Reference Frame in Functional Neuroimaging

Contemporary mental health practice primarily centers around the neurobiological and psychological processes at the individual level. However, a more careful consideration of interpersonal and other group-level attributes (e.g., interpersonal relationship, mutual trust/hostility, interdependence, and cooperation) and a better grasp of their pathology can add a crucial dimension to our understanding of mental health problems. A few recent studies have delved into the interpersonal behavioral processes in the context of different psychiatric abnormalities. Neuroimaging can supplement these approaches by providing insight into the neurobiology of interpersonal functioning. Keeping this view in mind, we discuss a recently developed approach in functional neuroimaging that calls for a shift from a focus on neural information contained within brain space to a multi-brain framework exploring degree of similarity/dissimilarity of neural signals between multiple interacting brains. We hypothesize novel applications of quantitative neuroimaging markers like inter-subject correlation that might be able to evaluate the role of interpersonal attributes affecting an individual or a group. Empirical evidences of the usage of these markers in understanding the neurobiology of social interactions are provided to argue for their application in future mental health research