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BMJ Case Reports May 2019Dopamine dysregulation syndrome is a rare complication of Parkinson's disease (PD) treatment. We present a 70-year-old woman with a long-standing PD and a clinical...
Dopamine dysregulation syndrome is a rare complication of Parkinson's disease (PD) treatment. We present a 70-year-old woman with a long-standing PD and a clinical picture compatible with dopaminergic dysregulation, which was ultimately revealed to be induced by her companion. Patient's exuberant choreiform dyskinesia led to a potential financial advantage when performed outside the hospital but excessive dopamine intake also occurred during hospital admission, without any obvious reward for the abuser. Even in cases where there is no place for a definitive diagnosis, deceptive behaviours must be identified as their management is based on psychological and social support in parallel to the adjustment of PD therapy.
Topics: Aged; Carbidopa; Disruptive, Impulse Control, and Conduct Disorders; Drug Combinations; Female; Humans; Levodopa; Parkinson Disease; Substance-Related Disorders; Syndrome
PubMed: 31101748
DOI: 10.1136/bcr-2018-228495 -
British Medical Journal May 1976The effects of administration of methyldopa on serum prolactin and growth hormone (GH) concentrations in hypertensive patients were studied. Single doses of methyldopa... (Clinical Trial)
Clinical Trial
The effects of administration of methyldopa on serum prolactin and growth hormone (GH) concentrations in hypertensive patients were studied. Single doses of methyldopa (750 or 1000 mg) significantly increased serum prolactin levels, peak concentrations occurring four to six hours after drug administrations. Long-term methyldopa treatment was associated with threefold to fourfold increases in basal prolactin levels compared with those in normal subjects. In patients treated with methyldopa for two to three weeks the GH response to insulin hypoglycaemia was significantly greater than in normal subjects and untreated hypertensive patients. In contrast, patients treated for prolonged periods (mean 13-4 months) had a GH reponse indistinguishable from normal.
Topics: Adult; Bethanidine; Female; Growth Hormone; Humans; Hypertension; Hypoglycemia; Insulin; Male; Methyldopa; Middle Aged; Prolactin
PubMed: 1268617
DOI: 10.1136/bmj.1.6019.1186 -
Journal of Neural Transmission (Vienna,... Nov 2023Pump-guided intrajejunal levodopa administration is one of the indispensable forms of therapy in advanced Parkinson's syndrome, along with deep brain stimulation and...
Pump-guided intrajejunal levodopa administration is one of the indispensable forms of therapy in advanced Parkinson's syndrome, along with deep brain stimulation and subcutaneous apomorphine injection. The standard application of levodopa gel via a JET-PEG, i.e. a percutaneous endoscopic gastrostomy (PEG) with an inserted internal catheter into the jejunum, has not been unproblematic due to the restricted absorption area of the drug in the region of the flexura duodenojejunalis and especially due to the sometimes considerable accumulated complication rates of a JET-PEG. Causes of complications are mainly a non-optimal application technique of PEG and internal catheter as well as the often missing adequate follow-up care. This article presents the details of a-compared to the conventional technique-modified and optimised application technique, which has been clinically proven successfully for years. However, many details derived from anatomical, physiological, surgical and endoscopic aspects must be strictly observed during the application to reduce or avoid minor and major complications. Local infections and buried bumper syndrome cause particular problems. The relatively frequent dislocations of the internal catheter (which can ultimately be avoided by clip-fixing the catheter tip) also prove to be particularly troublesome. Finally, using the Hybrid technique, a new combination of an endoscopically controlled gastropexy with 3 sutures and subsequent central thread pull-through (TPT) of the PEG tube, the complication rate can be dramatically reduced and thus a decisive improvement achieved for patients. The aspects discussed here are highly relevant for all those involved in the therapy of advanced Parkinson's syndrome.
Topics: Humans; Levodopa; Parkinson Disease; Carbidopa; Enteral Nutrition; Gastrostomy
PubMed: 36809488
DOI: 10.1007/s00702-023-02601-0 -
Neurology India 2016
Topics: Carbidopa; Eosinophilia; Fasciitis; Humans
PubMed: 26755008
DOI: 10.4103/0028-3886.173656 -
BMJ Case Reports Feb 2014A 34-year-old woman, with a history of pre-eclampsia, was diagnosed with α-methyldopa-induced hepatotoxicity, after she presented with severe jaundice and hepatitis 8...
A 34-year-old woman, with a history of pre-eclampsia, was diagnosed with α-methyldopa-induced hepatotoxicity, after she presented with severe jaundice and hepatitis 8 weeks following delivery. Laboratory investigations and liver biopsy ruled out other causes of hepatitis. She continued to improve clinically after cessation of α-methyldopa, and was discharged 10 days after admission. This case report emphasises that it may not be possible to predict which patients may develop α-methyldopa-induced hepatitis, hence regular monitoring of liver function tests during treatment should be implemented.
Topics: Adult; Antihypertensive Agents; Chemical and Drug Induced Liver Injury; Female; Humans; Methyldopa; Postpartum Period; Pre-Eclampsia; Pregnancy
PubMed: 24577181
DOI: 10.1136/bcr-2014-203712 -
British Medical Journal Jan 1977Combined treatment with low doses of different drugs is widely used for moderate hypertension. The effects of atenolol and methyldopa at two dose levels and in... (Clinical Trial)
Clinical Trial
Combined treatment with low doses of different drugs is widely used for moderate hypertension. The effects of atenolol and methyldopa at two dose levels and in combination at the lower doses were studied in patients with moderate hypertension on continuous treatment with moderate hypertension on continuous treatment with chlorthalidone. The mean reduction in standing blood pressures obtained with atenolol 150 and 300 mg/day was about 27/17 mm Hg and with methyldopa 750 and 1500 mg/day about 28/14 mm Hg. Combined treatment with atenolol 150 mg/day and methyldopa 750 mg/day for four weeks resulted in a reduction of 38/25 mm Hg. No difference was observed between the two doses of methyldopa. The lower dose of atenolol was better than the lower dose of methyldopa in reducing lying and standing diastolic blood pressures. These findings show that in patients on continuous treatment with chlorthalidone the addition of atenolol alone or methyldopa alone or of atenolol and methyldopa in combination is effective in the treatment of moderate hypertension.
Topics: Adrenergic beta-Antagonists; Adult; Atenolol; Chlorthalidone; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Hypertension; Male; Methyldopa; Middle Aged; Propanolamines
PubMed: 12850
DOI: 10.1136/bmj.1.6053.76 -
The Journal of the Royal College of... Jan 1969
Topics: Anemia, Hemolytic, Autoimmune; Antibody Formation; Coombs Test; Humans; Male; Methyldopa; Middle Aged
PubMed: 5774135
DOI: No ID Found -
Cardiovascular Journal of AfricaPre-eclampsia complicated by pulmonary oedema, severe hypertension, tachycardia and desaturation is a devastating condition. A comprehensive understanding of the...
Pre-eclampsia complicated by pulmonary oedema, severe hypertension, tachycardia and desaturation is a devastating condition. A comprehensive understanding of the aetiopathogenesis during such an emergency is challenging in the absence of functional and responsive point-of-care imaging, and laboratory and other critical-care services. An unbooked 26-year-old gravida 3 para 1+1 presented to a primary healthcare clinic with features of pre-eclampsia, severe hypertension and pulmonary oedema. The only available antihypertensive drug, methyldopa, was administered. The patient was transferred to a district hospital and subsequently referred to a tertiary hospital. On arrival, she was booked for caesarean delivery and in the maternity ward a central venous pressure (CVP) line was inserted. The patient developed pneumothorax and died in the intensive care unit undelivered. This case highlights many lessons, which are discussed. If CVP monitoring is indicated before caesarean delivery, consideration must be given to line insertion in the operating room to facilitate rapid delivery should the patient's condition deteriorate.
Topics: Female; Pregnancy; Humans; Adult; Pre-Eclampsia; Pulmonary Edema; Antihypertensive Agents; Methyldopa; Hypertension
PubMed: 35175275
DOI: 10.5830/CVJA-2021-064 -
British Journal of Clinical Pharmacology Mar 1985The mechanism of the antihypertensive effect of alpha-methyldopa was compared with clonidine by administering equipotent single doses of clonidine (0.2 mg) and... (Clinical Trial)
Clinical Trial Comparative Study
The mechanism of the antihypertensive effect of alpha-methyldopa was compared with clonidine by administering equipotent single doses of clonidine (0.2 mg) and alpha-methyldopa (750 mg) to nine hypertensive patients. Plasma noradrenaline was followed for 8 h thereafter as an index of peripheral sympathetic activity. alpha-Methyldopa and clonidine produced the same hypotensive response at 6 and 8 h after dosing with a similar fall in plasma noradrenaline levels at these times. Linear regression analysis between the systolic blood pressure fall and the corresponding plasma noradrenaline fall, showed that the slopes of the two regression lines were similar for alpha-methyldopa as for clonidine. Equipotent doses of alpha-methyldopa and clonidine produce the same fall in plasma noradrenaline. This supports the current hypothesis that an alpha-methyldopa metabolite acts centrally, like clonidine, to reduce peripheral sympathetic activity.
Topics: Adult; Aged; Blood Pressure; Clonidine; Double-Blind Method; Growth Hormone; Humans; Hypertension; Hypnotics and Sedatives; Methyldopa; Middle Aged; Norepinephrine; Random Allocation; Time Factors
PubMed: 3986086
DOI: 10.1111/j.1365-2125.1985.tb02649.x -
British Medical Journal Nov 1971
Topics: Diazoxide; Humans; Hypotension; Hypotension, Orthostatic; Methyldopa
PubMed: 5128223
DOI: 10.1136/bmj.4.5786.560-c