Why are about 15% of persons with Parkinson’s prone to exhibit behaviors such as excessive libido which can be very severe and disruptive to relationships, as well as “punding,” which includes excessive gambling and shopping?

There is a well- recognized direct and independent relationship between depression and Parkinson’s. But a similar connection has not been established for bipolar disorder which consists of recurrent depression as well as mania.

A new study from Taiwan may shed some light here. Researchers had access to a database that includes almost 100% of all 23 million Taiwanese. A significant increase in bipolar disorder was found, similar to the results of a Swedish study.

Medications that treat Parkinson’s increase dopamine in the brain and can trigger mania, and mood stabilizers used to treat mania often worsen motor symptoms of Parkinson’s.

A conundrum.

See the editorial by Pontone and Koch in Neurology, June 11, 2019.

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