Of 88 patients with idiopathic Parkinson's disease, without prior
psychotic symptoms, and without significant dementia, nearly half had
experienced vivid dreams, hallucinations, illusions, and nonconfusional as
well as confusional psychoses as side effects of chronic levodopa therapy
within the previous year of treatment. It was found that 61.3% of all
hallucinations were associated with preexistent or concurrent vivid dream
phenomena, that all psychotic states were associated with preexistent or
concurrent vivid dreams and/or hallucinations, and that nonconfusional
psychotic states tended to become confusional. These findings raise the
possibility that chronic levodopa therapy may result in dopaminergic
kindling and support the hypothesis that chronic dopaminergic agonism may,
via such a kindling mechanism, play a role in the development of some types
of psychoses.Abstract Teaser