Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide
Background. The pharmacological treatment options of Parkinson’s disease (PD) have considerably evolved during the last decades. However, therapeutic regimes are complicated due to individual differences in disease progression as well as the occurrence of complex nonmotor impairments such as mood an...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2021/8868023 |
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| author | Marc Praetner Timo Schiele Lukas Werle Janina Kuffer Sandra Nischwitz Martin E. Keck Stefan Kloiber |
| author_facet | Marc Praetner Timo Schiele Lukas Werle Janina Kuffer Sandra Nischwitz Martin E. Keck Stefan Kloiber |
| author_sort | Marc Praetner |
| collection | DOAJ |
| description | Background. The pharmacological treatment options of Parkinson’s disease (PD) have considerably evolved during the last decades. However, therapeutic regimes are complicated due to individual differences in disease progression as well as the occurrence of complex nonmotor impairments such as mood and anxiety disorders. Antidepressants in particular are commonly prescribed for the treatment of depressive symptoms and anxiety in PD. Case Presentation. In this case report, we describe a case of a 62-year-old female patient with PD and history of depressive symptoms for which she had been treated with moclobemide concurrent with anti-Parkinson medications pramipexole, rasagiline, and L-DOPA+benserazide retard. An increase in the dosage of moclobemide 12 months prior to admission progressively led to serotonergic overstimulation and psychovegetative exacerbations mimicking the clinical picture of an anxiety spectrum disorder. After moclobemide and rasagiline were discontinued based on the hypothesis of serotonergic overstimulation, the patient’s psychovegetative symptoms subsided. Conclusions. The specific pharmacological regime in this case probably caused drug-drug interactions resulting in a plethora of psychovegetative symptoms. Likely due to the delayed onset of adverse effects, physicians had difficulties in determining the pharmacologically induced serotonin toxicity. This case report emphasizes the complexity of pharmacological treatments and the importance of drug-drug interaction awareness in the treatment of PD patients with complicating nonmotor dysfunctions such as depression. |
| format | Article |
| id | doaj-art-5e1f55709e404adbac37e1796a545b8e |
| institution | OA Journals |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-5e1f55709e404adbac37e1796a545b8e2025-08-20T02:06:00ZengWileyCase Reports in Psychiatry2090-682X2090-68382021-01-01202110.1155/2021/88680238868023Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with MoclobemideMarc Praetner0Timo Schiele1Lukas Werle2Janina Kuffer3Sandra Nischwitz4Martin E. Keck5Stefan Kloiber6Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, GermanyPsychosomatische Klinik Kloster Dießen GmbH & Co. KG, Klosterhof 20, 86911 Dießen am Ammersee, GermanyBenedictus Krankenhaus Tutzing Bahnhofstraße 5, 82327 Tutzing, GermanyAlgesiologikum GmbH, Heßstr. 22, 80799 Munich, GermanyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyKliniken Schmieder 78260 Gailingen am Hochrhein, GermanyMax Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, GermanyBackground. The pharmacological treatment options of Parkinson’s disease (PD) have considerably evolved during the last decades. However, therapeutic regimes are complicated due to individual differences in disease progression as well as the occurrence of complex nonmotor impairments such as mood and anxiety disorders. Antidepressants in particular are commonly prescribed for the treatment of depressive symptoms and anxiety in PD. Case Presentation. In this case report, we describe a case of a 62-year-old female patient with PD and history of depressive symptoms for which she had been treated with moclobemide concurrent with anti-Parkinson medications pramipexole, rasagiline, and L-DOPA+benserazide retard. An increase in the dosage of moclobemide 12 months prior to admission progressively led to serotonergic overstimulation and psychovegetative exacerbations mimicking the clinical picture of an anxiety spectrum disorder. After moclobemide and rasagiline were discontinued based on the hypothesis of serotonergic overstimulation, the patient’s psychovegetative symptoms subsided. Conclusions. The specific pharmacological regime in this case probably caused drug-drug interactions resulting in a plethora of psychovegetative symptoms. Likely due to the delayed onset of adverse effects, physicians had difficulties in determining the pharmacologically induced serotonin toxicity. This case report emphasizes the complexity of pharmacological treatments and the importance of drug-drug interaction awareness in the treatment of PD patients with complicating nonmotor dysfunctions such as depression.http://dx.doi.org/10.1155/2021/8868023 |
| spellingShingle | Marc Praetner Timo Schiele Lukas Werle Janina Kuffer Sandra Nischwitz Martin E. Keck Stefan Kloiber Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide Case Reports in Psychiatry |
| title | Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide |
| title_full | Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide |
| title_fullStr | Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide |
| title_full_unstemmed | Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide |
| title_short | Chronic Serotonergic Overstimulation Mimicking Panic Attacks in a Patient with Parkinson’s Disease Receiving Additional Antidepressant Treatment with Moclobemide |
| title_sort | chronic serotonergic overstimulation mimicking panic attacks in a patient with parkinson s disease receiving additional antidepressant treatment with moclobemide |
| url | http://dx.doi.org/10.1155/2021/8868023 |
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