Dopamine Hypothesis – Medication of Movement Disorders

by Pravin Shukle, MD

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    00:01 Welcome to pharmacology by Lecturio. My name is Dr. PJ Shukle. We are going to be covering Parkinson's disease and other movement disorders and the drugs that we use to help control them.

    00:15 The dopamine hypothesis of how the brain works is quite interesting. Reduced dopamine levels are seen in patients with Parkinson's disease. So quite naturally we as physicians want to increase those levels.

    00:28 So we give dopamine agonist. We give dopamine agonist to these patients with Parkinson's disease to mitigate their symptoms but long term exposure to these medications results in increasing schizophrenic type symptoms and mania and psychotic symptoms. We know also that treatment of schizophrenia involves reducing dopamine levels. So you can see that there is a reaction and an interaction between Parkinson's disease and schizophrenia and mania. And the Chinese recognized this 2000 years ago when they recognized that Parkinson's disease type syndromes and psychotic diseae type syndromes were a Yin and Yang kind of relationship. Drugs used to treat psychosis and hyperactivity rely on reducing the levels of dopamine and dopamine transmission in the brain. And drugs used to treat Parkinson's disease and dyskinesias, rely on increasing those very same levels.

    01:33 Drugs used to treat Parkinson's disease can include dopamine precursors like levodopa, dopamine agonists, MAO inhibitors, and COMT inhibitors. Drugs used to treat other diseases include diseases like tremor, Wilson's disease, complex choreas, Huntington's disease, and Tourette's syndrome. Let's take a look at the brain. Now we already looked at this very same diagram when we were looking at our psychotic medication. So the effects of increasing dopamine are quite important. In the nigrostriatal tract, you improve extrapyramidal function and this causes an improvement in Parkinsonian symptoms.

    02:17 The same medications in the mesocortical and mesolimbic tracts cause apathy and lack of emotion, and hallucination and delusion. In the TI tract, this will stimulate prolactin release.

    02:31 And in the fourth pathway, you are effecting the chemoreceptor trigger zone. That houses the vomiting center of the brain and causes anorexia, nausea and vomiting. So these are important side effects of the medications that we use to treat Parkinson's disease.

    About the Lecture

    The lecture Dopamine Hypothesis – Medication of Movement Disorders by Pravin Shukle, MD is from the course CNS - Pharmacology.

    Included Quiz Questions

    1. Parkinson's Disease and Schizophrenia
    2. Depression and Schizophrenia
    3. Parkinson's Disease and Huntington's chorea
    4. Schizoaffective Disease and Schizophrenia
    5. Pregnancy and Menopause
    1. Mesolimbic tract
    2. Mesocortical tract
    3. Tuberoinfundibular tract
    4. Nigrostriatal tract
    5. Chemoreceptor zone

    Author of lecture Dopamine Hypothesis – Medication of Movement Disorders

     Pravin Shukle, MD

    Pravin Shukle, MD

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