THERAPEUTIC EFFECT OF CLOZAPINE IN PSYCHOTIC DECOMPENSATION IN IDIOPATHIC PARKINSONS-DISEASE

Seven patients with idiopathic Parkinson's disease, aged 62 to 76 year s, average duration of the disease approximately eleven years, sufferi ng from severe hallucinosis and paranoid delusions of different degree , in whom conventional therapeutic strategies (administration of benzo diazepines and mild neuroleptics) had no antipsychotic effect, receive d clozapine, a non-classical highly potent neuroleptic, while blood co unt was strictly monitored. Paranoid ideas disappeared in all seven pa tients after a maximum of four days administration of 25-125 mg/day. N o deterioration of parkinsonian symptoms, quantified according to UPDR S was seen. Given the protection of clozapine, we could increase the L -dopa dose in two cases, thereby improving the patients' motor functio n. Blood count showed no abnormalities in any of the patients during a n average observation period of seventeen months. Our results support the assumption that clozapine has a potent antipsychotic effect in the treatment of psychotic decompensation in advanced Parkinson's disease in carefully selected patients. We saw no negative influence of the n eurolpetic on extrapyramidal symptoms.