PSYCHOSIS DURING CHRONIC LEVODOPA THERAPY TRIGGERED THE NEW ANTIDEPRESSIVE DRUG MIRTAZAPINE

We report the case of a patient developing psychosis after the additio n of mirtazapine, a novel antidepressant enhancing serotonergic neurot ransmission, to a chronic levodopa regimen. There was complete and rap id recovery upon low-dose clozapine treatment. To our knowledge, this is the first published case of a mirtazapine-levodopa interaction and the second case report of a psychosis induced by a serotonergic antide pressant in a patient with Parkinson's disease (PD). This phenomenon m ight be due to a postsynaptic serotonin receptor supersensitization ca used by low central serotonin levels in treated PD.