Psychic Effects in Patients Treated With Levodopa

Abstract

To the Editor.— The letter of Drs. Tobias and Merlis ( 211 :1857,1970) reported their experience of the aggravation of psychiatric symptoms following the administration of levodopa to schizophrenic patients suffering from drug-induced parkinsonism, and the appearance of psychiatric symptoms in patients with Parkinson's disease. The production of psychotic and other mental symptoms in nonschizophrenic patients has been reported by others. 1-3 Bunney and coworkers 4 reported an apparent antidepressant action of levodopa but other authors have reported the appearance of severe depression in some patients. 3,5 A number of drugs and foods are reputed to antagonize the therapeutic effects of levodopa. They include monoamine oxidase inhibitors and psychic energizers, reserpine, phenothiazines, antiemetics, tranquillizers, and alpha methyldopa, 6 cheese, chocolate, and red wine, 7 butyrophenones, and pyridoxine. 8 Because of the lack of information on psychic features given in most articles, and because the warnings against certain other drugs appears to be