Sex, drugs and rock’n’roll
-
Upload
richard-mccrory -
Category
Health & Medicine
-
view
522 -
download
2
Transcript of Sex, drugs and rock’n’roll
![Page 1: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/1.jpg)
Sex, Drugs and Rock’n’Roll
A Secret Tale of Parkinsons Disease
![Page 2: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/2.jpg)
Objectives
• Brief overview of Parkinson’s Disease– The role of Dopamine– Clinical Features– Patho-physiology
• Treatment of PD– Psychological Side-effects
![Page 3: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/3.jpg)
Dopamine
• Catecholamine– Neurotransmitter– Neurohormone– Precursor to noradrenaline and
adrenaline
• Synthesised by most vertebrates and invertebrates
• 5 different receptors with different responses D1 – D5
![Page 4: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/4.jpg)
Dopamine(2)
• Made in nervous tissue and adrenal glands– Cannot cross the blood-brain barrier
• Inactivation– Broken down by Monoamine Oxidase (MAO)
and Catechol O-methyl transferase (COMT) in both brain and peripheral tissue
![Page 5: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/5.jpg)
Dopamine pathways in human brain
![Page 6: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/6.jpg)
Functions of Dopamine
In the Brain:Behaviour / Cognition
Voluntary movement
Motivation, punishment and reward
Inhibition of prolactin production
Sleep, mood, attention, working memory, and learning.
In peripheral tissue:Renal Blood flow / Blood Pressure / Cardiac Output
![Page 7: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/7.jpg)
Parkinsonism
• Caused by insufficient formation or action of dopamine in the brain
• Three cardinal symptoms:– resting tremor– bradykinesia
(generalized slowness of movements)
– muscle rigidity
![Page 8: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/8.jpg)
‘An Essay on the Shaking Palsy’
• First described by an English physician, James Parkinson, in 1817– ‘Paralysis Agitans’– 6 individuals observed on daily walks
• Parkinsons Disease is chronic progressive parkinsonism caused by loss of dopamine producing neurons in the brain
![Page 9: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/9.jpg)
Epidemiology of PD
• The most common movement disorder affecting 1-2 % of the general population over the age of 65 years.– The second most common neurodegenerative
disorder after Alzheimer´s disease (AD).
![Page 10: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/10.jpg)
Other Important Symptoms
Pain
Postural instability/Altered perception– Autonomic disturbances
Mental health problems– Sleep– Anxiety /Apathy / Depression– Dementia
![Page 11: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/11.jpg)
Drug Therapy for Parkinson’s Disease
Drug therapy does not prevent disease progression, but it improves most patients' quality of life.
Strategies:1. Improve production of Dopamine2. Mimic Dopamine Effects3. Prevent Breakdown of Dopamine in the
brain
![Page 12: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/12.jpg)
Drug Therapies
Dopamine Receptor Agonistse.g. Bromocriptine
MAO-B Inhibitorse.g. Selegiline
L-Dopa (Levodopa)– Pre-cursor of Dopamine– Crosses Blood Brain Barrier– Given with medication to inhibit peripheral
conversion of L-Dopa to Dopamine
![Page 13: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/13.jpg)
Problems with L-Dopa Therapy
Side effects on rest of bodyMotor Complications
Fluctuating response to treatment- ‘On/Off’ Periods- ‘End-of-Dose’ deterioration
Non-Motor Complications– Vivid dreams and sleep disturbances– Psychosis / Mental Health Disturbances– Impulse Control Disorders
![Page 14: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/14.jpg)
Impulse Control Disorders and PD
• Impulse control disorders– Repetitive, excessive and compulsive activities that
interfere with life functioning.• Compulsive eating• Pathological gambling• Compulsive shopping• Hypersexuality / Inappropriate sexualised behaviour
• ‘Punding’– Complex stereotyped behaviours characterised by
intense fascination with an excessive, repetitive activity.
![Page 15: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/15.jpg)
Dopamine Dysregulation Syndrome
Need for increasing and excessive doses of dopamine replacement therapy DRT)
Pattern of pathological use: expressed need for increased DRT in the presence of side effects despite being ‘‘on’’, drug-hoarding or drug-seeking behaviour, unwillingness to reduce DRT
Impairment of social or occupational functioning
Development of hypomania, manic or cyclothymic affective syndrome in relation to DRT.
Development of a withdrawal state characterised by dysphoria, depression, irritability and anxiety on reducing the level of DRT
![Page 16: Sex, drugs and rock’n’roll](https://reader036.fdocuments.in/reader036/viewer/2022062319/5553a63ab4c905d4448b4618/html5/thumbnails/16.jpg)
Summary
The Role of Dopamine in Parkinson’s Disease
The Importance of Dopamine Replacement Therapy– ‘Blessings and Curses’– Dopamine Dysregulation Syndrome