Table 1

Patients' description

No Sex Age of onset Preceding psychiatric history Family history Previous history of substance misuse Motor complications Mood disorder Behavioural disorder Interpersonal relationships Employment history Max daily levodopa
Max daily oral dopamine agonist dose Max daily apopmorphine dose Comments
1M36DepressionDepressionEx-smoker, moderate alcohol consumptionDyskinesias, motor blocks, on-offs unpredictable dose effectCyclothymicHypersexualityLong history of marital difficultiesEarly retirement due to PD3200 mgTrials of bromocriptine (max daily dose 15 mg)170 mgAdmitted several times with acute psychosis related to apomorphine abuse
2F39Depression, panic attacks as a teenagerNilNilDyskinesias, motor blocks, on-offsDepression and hypomanic episodesAnxiety, panic attacksNilEarly retirement1875 mgPergolide 1.5 mg138 mgAdmitted with hypomania and a paranoid delusional disorder
3 M40Mild pre-morbid depressionNilNilDyskinesias, rapid on-offs, unpredictable dose effectDepressionExhibitionismFamily difficultiesEarly retirement2125 mgnil110 mgTried continuous apomorphine infusion but missed the “hit” of the intermittent injection. Despite increasing dyskinesias felt under medicated.
4M42NilNilNilMotor fluctuations, dyskinesias, on-offs unpredictable dose effectManic psychosisDisinhibited, hypersexualtyDivorced due to behavioural disorderEarly retirement5500 mgBromocriptine 70 mg75 mgPreferred intermittent apomorphine injections to continuous subcutaneous infusion