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Parkinson's Drug May Spur Hallucinations NEW YORK (Reuters) May 11, 1998 - Auditory hallucinations (such as "hearing voices") may be a side effect of levodopa (L-dopa), the drug most commonly used to treat Parkinson's disease. "Hallucinations are common side effects of dopaminergic drugs (such as L-dopa) used in Parkinson's disease," according to researchers at Tel-Aviv University in Ramat-Aviv, Israel. The report was published recently in the Journal of Neurology, Neurosurgery and Psychiatry. Parkinson's disease is a degenerative neurological disorder characterized by tremor, a loss of facial expression, and gradual losses in motor control. Experts estimate that the illness affects about 1% of people aged 65 and over. Drug treatments that enhance the supply of the neurotransmitter dopamine in the brain can slow or even reverse Parkinson's symptoms. Neurologists have long known that L-dopa and other dopamine-stimulating drugs sometimes trigger visual hallucinations. In their current study, the Israeli researchers sought to discover if patients were experiencing auditory hallucinations as well. After interviewing 121 Parkinson's patients, they found that "45 (37%) reported having experienced hallucinations at present or within the preceding 2 years. Thirty five (29%) had only visual hallucinations, whereas 10 (8%) had both visual and auditory hallucinations." Auditory hallucinations usually involved "hearing voices." The coherence of these voices varied from patient to patient. One woman regularly heard her (deceased) husband's voice commenting on her daily activities, while for other patients the voices had little relevance to their lives and were often incoherent. "No relationship existed between visual and auditory hallucinations," the investigators report. "The voices were never accompanied by an image...." All of those afflicted with auditory phenomena were taking L-dopa or similar medications at the time, although the authors caution that "we cannot prove that the patients' symptoms were related to drugs." Discontinuing some antiparkinsonian medications or treatment with the antipsychotic clozapine were effective in preventing hallucinations in several patients. The researchers believe the auditory hallucinations of many Parkinson's patients may go undetected by doctors and caregivers. Most of the study participants suffering from these disturbances "expressed some embarrassment about revealing that they had been hearing voices," the authors report. They urge that questions aimed at uncovering hallucinatory phenomenon become a standard part of regular examinations of Parkinson's patients. SOURCE: Journal of Neurology, Neurosurgery and Psychiatry (1998;64:533-535) Copyright 1998 Reuters Limited. janet paterson 51/10 - sinemet/selegiline/prozac almonte/ontario/canada - [log in to unmask]