Aripiprazole in patients with psychosis associated with Parkinson's disease: Two case reports

Parkinson's disease is among the most frequent neurodegenerative diseases. In idiopathic parkinson's disease, degeneration of dopaminergic neurons of nigrostriatal pathway charging to inhibit the GABA ergic neurons' activity, leads dopamine inadequacy. Symptomatic treatment for this disease aims to enhance the declined dopaminergic transmission. Levodopa preparates are first choice medicine for this purpose. Levodopa is the precursor of dopamine. When used at high doses and prolonged periods, in the course of time, some side effects like fluctuation of motor response, on-off phonemon free of dosage effect and involuntary movements may emerge. At times, psychosis cases related to parkinsonism treatment are reported in the medical literature. Pharmacologic studies have shown that aripiprazole has a high affinity to dopamine receptors and acts as a partial agonist on them. In the light of partial agonism, even though limited, there are studies concerning aripiprazole usage, for treatment of psychotic symptoms arising in the course of parkinson's treatment. Here, we will present two cases who exposed psychotic symptoms in the course of treatment for parkinsonism and had less psychotic symptoms and extrapyramidal side effects like tremor and rigidity after treatment with aripiprazole. In conclusion, according to us, in likely cases it is important for clinicians to take using aripiprazole into consideration in terms of alternative treatment options.