Othello syndrome after STN DBS – psychiatric side-effects of DBS and methods of dealing with them
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Oddział Chorób Afektywnych IPiN w Warszawie
Zakład Farmakologii IPiN w Warszawie
Klinika Neurochirurgii IPiN w Warszawie
Submission date: 2014-10-16
Final revision date: 2014-11-16
Acceptance date: 2014-11-16
Publication date: 2016-04-30
Corresponding author
Anna Zofia Antosik-Wójcińska   

Instytut Psychiatrii i Neurologii, Sobieskiego 9, 02-957 Warszawa, Polska
Psychiatr Pol 2016;50(2):323-327
Deep brain stimulation is a therapeutic method used for decades in neurological diseases such as Parkinson’s disease or dystonia. Despite many publications concerning DBS, there are few publications on psychotic symptoms after DBS, there are also no standards of dealing with them.

The authors present a case of a patient with Parkinson’s disease, in whom psychotic symptoms in the form of Othello-like syndrome appeared after implantation of a stimulator. In this case the strategy of continuation of stimulation and adding antipsychotic drug (quetiapine) was chosen.

Gradual resolution of psychotic symptoms, without worsening of neurological symptoms and no recurrence of psychiatric symptoms was observed.

In recent years, work is underway on the use of DBS in psychiatry, particularly in patients with treatment-resistant depression. It is necessary to set the strategy for dealing with side-effects of DBS. Most of the authors prefer the temporary or permanent switch off the stimulator. In the author’s opinion, in some cases it is possible to effectively treat the psychotic symptoms without resignation from the benefits of stimulation. So far, however, such cases were described so rarely that it is difficult on this basis to formulate conclusions that can be applied to the whole population of patients treated with DBS. Only a systematic study including an assessment of psychotic symptoms using scales and analysing the received treatment and stimulation parameters could give an idea of what is the most appropriate strategy in case of psychosis following DBS.

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