Zoophilia in a patient with Parkinson's disease

Abstract

IntroductionParkinson's disease (PD) is a neurodegenerative brain disorder characterized by Bradykinesia, muscle rigidity and resting tremor. Non-motor symptoms like neuropsychiatric manifestations can also cause significant morbidity. Common medications used in anti-Parkinsonian treatment such as dopaminergic agonists, may help motor symptoms but can also cause or contribute to adverse behavioral manifestations. These include dementia, depression, anxiety, insomnia, psychosis and paraphilic disorders. There are sporadic reports of zoophilia in association with dopaminergic therapy.ObjectivesReport of a clinical case of PD and zoophilia.Aimsclinicians must be aware of paraphilic disorders, namely zoophilia, in patients with dopaminergic medication.MethodSearch of the Pubmed database was conducted for articles published that had “zoophilia [All Fields] and Parkinson [All Fields]”, resulting in 3 eligible articles through October 2016. The patient's clinical records were also reviewed.Case ReportA 77-year-old man, living in a rural area and with a low educational background, with akinetic–rigid PD in an advanced stage and followed by neurology since 2003. His family physician sent him to a psychiatric assessment for hyper-sexuality with zoophilia. The psychiatrist found that these behaviors had begun a week after levodopa was increased along with the introduction of selegiline. The psychiatrist has introduced quetiapine with significant decrease of the hyper-sexuality and the end of zoophilic episodes.ConclusionDespite hyper-sexuality is found in just 2–6% of PD patients in connection with dopaminergic treatment. This case report emphasizes how crucial it is to evaluate PD patients’ sexuality as well as to explain these adverse effects to the families involved.Disclosure of interestThe authors have not supplied their declaration of competing interest.