[Psychiatric complications of L-dopa: physiopathology and treatment]

This review article deals with the psychiatric complications of L-dopa in Parkinson's disease. There is a 20% incidence of these complications with estimations varying in the different publications between 10% and 50%. They usually occur after several years of treatment. The complications are varieds and include anxiety states, affective disorders, psychoses, disorders of recognition and other mental disorders. They may be explained in physio-pathological terms as an alteration of the dopaminergic system of the mesolimbic and mesocortical circuits. Treatment should be adjusted individually. In most cases the dosage of levodopa should be lowered or stopped altogether. In other patients treatment with benzodiazepines, neuroleptic antidepressants and even electric shock treatment may be necessary.