The management of psychosis in movement disorder patients

Expert Opinion on Pharmacotherapy

Volumn 8, Issue 7, 2007, Pages 935-943

  Chou, Kelvin L ^a,b   Borek, Leora L ^b,c   Friedman, Joseph H ^a,b  

^a BROWN UNIVERSITY   (United States)

^b NeuroHealth Parkinson's Disease and Movement Disorders Center   (United States)

^c BUTLER HOSPITAL   (United States)

Author keywords

Antipsychotics; Cholinesterase inhibitors; Dementia with Lewy bodies; Huntington's disease; Movement disorders; Parkinson's disease; Psychosis

Indexed keywords

ARIPIPRAZOLE; ATYPICAL ANTIPSYCHOTIC AGENT; CHOLINESTERASE INHIBITOR; CLOZAPINE; DONEPEZIL; GALANTAMINE; HALOPERIDOL; LEVODOPA; NEUROLEPTIC AGENT; OLANZAPINE; ONDANSETRON; PLACEBO; QUETIAPINE; RISPERIDONE; RIVASTIGMINE; ZIPRASIDONE;

AGRANULOCYTOSIS; CLINICAL FEATURE; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; DELUSION; DEMENTIA; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG RESPONSE; DRUG SAFETY; DRUG TOLERABILITY; ELECTROCONVULSIVE THERAPY; EXTRAPYRAMIDAL SYMPTOM; FALLING; GASTROINTESTINAL SYMPTOM; HALLUCINATION; HUMAN; HUNTINGTON CHOREA; HYPERSALIVATION; HYPOTENSION; LEWY BODY; LOW DRUG DOSE; MONOTHERAPY; MORTALITY; MOTOR DYSFUNCTION; ORTHOSTATIC HYPOTENSION; PARKINSON DISEASE; PARKINSONISM; PSYCHOSIS; REVIEW; SALIVATION; SCHIZOPHRENIA; SEDATION; SIDE EFFECT; DIFFUSE LEWY BODY DISEASE; PATIENT EDUCATION; PSYCHOLOGICAL ASPECT;

ANTIPSYCHOTIC AGENTS; CLOZAPINE; HALOPERIDOL; HUMANS; HUNTINGTON DISEASE; LEWY BODY DISEASE; PARKINSON DISEASE; PATIENT EDUCATION; PSYCHOTIC DISORDERS; RISPERIDONE;

EID: 34249680787     PISSN: 14656566     EISSN: None     Source Type: Journal    
DOI: 10.1517/14656566.8.7.935     Document Type: Review

References (104)

1. CHOU KL, FERNANDEZ HH: Combating psychosis in Parkinson's disease patients: the use of antipsychotic drugs. Expert Opin. Investig. Drugs (2006) 5(4):339-349.
2. AMERICAN PSYCHIATRIC ASSOCIATION: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (DSM-IV-TR). (ed.) American Psychiatric Association, Washington, DC, USA (2000).
3. HELY MA, MORRIS JG, REID WG, TRAFFICANTE R: Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years. Mov. Disord. (2005) 20(2):190-199.
4. SCHRAG A, HOVRIS A, MORLEY D, QUINN N, JAHANSHAHI M: Caregiver-burden in Parkinson's disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat. Disord. (2006) 12(1):35-41,
5. GOETZ CG, STEBBINS GT: Risk factors for nursing home placement in advanced Parkinson's disease. Neurology (1993) 43(11):2227-2229.
6. SANCHEZ-RAMOS JR, ORTOLL R, PAULSON GW: Visual hallucinations associated with Parkinson's disease. Arch. Neurol. (1996) 53(12):1265-1268.
7. FENELON G, MAHIEUX F, HUON R, ZIEGLER M: Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. Brain (2000) 123(Pt 4):733-745.
8. HOLROYD S, CURRIE L, WOOTEN GF: Prospective study of hallucinations and delusions in Parkinson's disease. J. Neurol. Neurosurg. Psychiatry (2001) 70(6):734-738.
9. DEWEY RB Jr. O'SUILLEABHAIN PE: Treatment of drug-induced psychosis with quetiapine and clozapine in Parkinson's disease. Neurology (2000) 55(11):1753-1754.
10. FACTOR SA, MOLHO ES, PODSKALNY GD, BROWN D: Parkinson's disease: drug-induced psychiatric states. Adv. Neurol. (1995) 65:115-138.
11. RAVINA B, MARDER K, FERNANDEZ HH et al.: Diagnostic Criteria for Psychosis in Parkinson's disease: Report of an NINDS/NIMH Work Group. Mov. Disord. (2007):in press.
12. AARSLAND D, LARSEN JP, CUMMINS JL, LAAKE K: Prevalence and clinical correlates of psychotic symptoms in Parkinson's disease: a community-based study. Arch. Neurol. (1999) 56(5):595-601.
13. BARNES J, DAVID AS: Visual hallucinations in Parkinson's disease: a review and phenomenological survey. J. Neurol. Neurosurg. Psychiatry (2001) 70(6):727-733.
14. FRIEDMAN JH, FACTOR SA: A typical antipsychotics in the treatment of drug-induced psychosis in Parkinson's disease. Mov. Disord. (2000) 15(2):201-211.
15. FRIEDMAN JH, LANNON MC: Clozapine-responsive tremor in Parkinson's disease. Mov. Disord. (1990) 5(3):225-229.
16. WOLTERS EC, HURWITZ TA, MAK E et al.: Clozapine in the treatment of parkinsonian patients with dopaminomimetic psychosis. Neurology (1990) 40(5):832-834.
17. FACTOR SA, BROWN D, MOLHO ES, PODSKALNY GD: Clozapine: a 2-year open trial in Parkinson's disease patients with psychosis. Neurology (1994) 44(3 Pt 1):544-546.
18. KAHN N, FREEMAN A, JUNCOS JL, MANNING D, WATTS RL: Clozapine is beneficial for psychosis in Parkinson's disease. Neurology (1991) 41(10):1699-1700.
19. PARKINSON STUDY GROUP: Low-dose clozapine for the treatment of drug-induced psychosis in Parkinson's disease. N. Engl. J. Med. (1999) 340(10):757-763.
20. POLLAK P, TISON F, RASCOL O et al.: Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up. J. Neurol. Neurosurg. Psychiatry (2004) 75(5):689-695.
21. MIYASAKI JM, SHANNON K, VOON V et al.: Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson's disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology (2006) 66(7):996-1002.
22. RICH SS, FRIEDMAN JH, OTT BR: Risperidone versus clozapine in the treatment of psychosis in six patients with Parkinson's disease and other akinetic-rigid syndromes. J. Clin. Psychiatry (1995) 56(12):556-559.
23. FORD B, LYNCH T, GREENE P: Risperidone in Parkinson's disease. Lancet (1994) 344(8923):681.
24. MECO G, ALESSANDRIA A, BONIFATI V, GIUSTINI P: Risperidone for hallucinations in levodopa-treated Parkinson's disease patients. Lancet (1994) 343(8909):1370-1371.
25. MOHR E, MENDIS T, HILDEBRAND K, DE DEYN PP: Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: an open pilot trial. Mov. Disord (2000) 15(6):1230-1237.
26. WOLTERS EC, JANSEN EN, TUYNMAN-QUA HG, BERGMANS PL: Olanzapine in the treatment of dopaminomimetic psychosis in patients with Parkinson's disease. Neurology (1996) 47(4):1085-1087.
27. FRIEDMAN JH, GOLDSTEIN S, JACQUES C: Substituting dozapine for olanzapine in psychiatrically stable Parkinson's disease patients: results of an open label pilot study. Clin. Neuropharmacol. (1998) 21(5):285-288.
28. FRIEDMAN J: Olanzapine in the treatment of dopaminomimetic psychosis in patients with Parkinson's disease. Neurology (1998) 50(4):1195-1196.
29. GOETZ CG, BLASUCCI LM, LEURGANS S, PAPPERT EJ: Olanzapine and clozapine: comparative effects on motor function in hallucinating PD patients. Neurology (2000) 55(6):789-794.
30. BREIER A, SUTTON VK, FELDMAN PD et al.: Olanzapine in the treatment of dopamimetic-induced psychosis in patients with Parkinson's disease. Biol. Psychiatry (2002) 52(5):438-445.
31. ONDO WG, LEVY JK, VUONG KD, HUNTER C, JANKOVIC J: Olanzapine treatment for dopaminergic-induced hallucinations. Mov. Disord. (2002) 17(5): 1031-1035.
32. MERIMS D, BALAS M, PERETZ C, SHABTAI H, GILADI N: Rater-blinded, prospective comparison: quetiapine versus clozapine for Parkinson's disease psychosis. Clin. Neuropharmacol. (2006) 29(6):331-337.
33. MORGANTE L, EPIFANIO A, SPINA E et al.: Quetiapine and clozapine in parkinsonian patients with dopaminergic psychosis. Clin. Neuropharmacol. (2004) 27(4):153-156.
34. ONDO WG, TINTNER R, VOUNG KD, LAI D, RINGHOLZ G: Double-blind, placebo-controlled, unforced titration parallel trial of quetiapine for dopaminergic-induced hallucinations in Parkinson's disease. Mov. Disord. (2005) 20(8):958-963.
35. RABEY JM, PROKHOROV T, MINIOVICH A, KLEIN C: The effect of quetiapine in Parkinson's disease (PD) psychotic patients: a double-blind labeled study of three months duration. Mov. Disord. (2005) 20(Suppl. 10):S46.
36. KLEIN C, PROKHOROV T, MINIOVICH A, DOBRONEVSKY E, RABEY JM: Long-term follow-up (24 months) of quetiapine treatment in drug-induced Parkinson's disease psychosis. Clin. Neuropharmacol. (2006) 29(4):215-219.
37. LOPEZ DEL VAL LJ, SANTOS S: [Quetiapine and ziprasidone in the treatment of the psychotic disorders in Parkinson's disease]. Rev. Neurol. (2004) 39(7):661-667.
38. GOMEZ-ESTEBAN JC, ZARRANZ JJ, VELASCO F et al.: Use of ziprasidone in parkinsonian patients with psychosis. Clin. Neuropharmacol. (2005) 28(3):111-114.
39. SCHINDEHUTTE J, TRENKWALDER C: Treatment of drug-induced psychosis in Parkinson's disease with ziprasidone can induce severe dose-dependent off-periods and pathological laughing. Clin. Neurol. Neurosurg. (2007) 109(2):188-191.
40. MICHELI F, TAUBENSLAG N, GATTO E, SCORTICATI MC: Ziprasidone and psychosis in Parkinson's disease. Clin. Neuropharmacol. (2005) 28(5):254.
41. BAGNALL A, LEWIS RA, LEITNER ML: Ziprasidone for schizophrenia and severe mental illness. Cochrane Database Syst. Rev. (2000) (4):CD001945.
42. LOPEZ-MEZA E, RUIZ-CHOW A, RAMIREZ-BERMUDEZ J: Aripiprazole in psychosis associated with Parkinson's disease. J. Neuropsychiatry Clin. Neurosci. (2005) 17(3):421-422.
43. FERNANDEZ HH, TRIESCHMANN ME, FRIEDMAN JH: Aripiprazole for drug-induced psychosis in Parkinson's disease: preliminary experience. Clin. Neuropharmacol. (2004) 27(1):4-5.
44. FRIEDMAN JH, BERMAN RM, GOETZ CG et al.: Open-label flexible-dose pilot study to evaluate the safety and tolerability of aripiprazole in patients with psychosis associated with Parkinson's disease. Mov. Disord. (2006) 21(12):2078-2081.
45. LAWLER CP, PRIOLEAU C, LEWIS MM et al.: Interactions of the novel antipsychotic aripiptazole (OPC-14597) with dopamine and serotonin receptor subtypes. Neuropsychopharmacology (1999) 20(6):612-627.
46. FABBRINI G, BARBANTI P, AURILIA C et al.: Donepezil in the treatment of hallucinations and delusions in Parkinson's disease. Neurol Sci. (2002) 23(1):41-43.
47. BULLOCK R, LIBRETTO S: Risperidone in the treatment of psychoses in the elderly: a case report series. Eur. Psychiatry (2002) 17(2):96-103.
48. AARSLAND D, HUTCHINSON M, LARSEN JP: Cognitive, psychiatric and motor response to galantamine in Parkinson's disease with dementia. Int. J. Geriatr. Psychiatry (2003) 18(10):937-941.
49. RAVINA B, PUTT M, SIDEROWF A et al.: Donepezil for dementia in Parkinson's disease: a randomised, double blind, placebo controlled, crossover study. J. Neurol. Neurosurg. Psychiatry (2005) 76(7):934-939.
50. EMRE M, AARSLAND D, ALBANESE A et al.: Rivastigmine for dementia associated with Parkinson's disease. N. Engl. J. Med. (2004) 351(24):2509-2518.
51. ZOLDAN J, FRIEDBERG G, GOLDBERG-STERN H, MELAMED E: Ondansetron for hallucinosis in advanced Parkinson's disease. Lancet (1993) 341(8844):562-563.
52. ZOLDAN J, FRIEDBERG C, LIVNEH M, MELAMED E: Psychosis in advanced Parkinson's disease: treatment with ondansetron, a 5-HT3 receptor antagonist. Neurology (1995) 45(7): 1305-1308.
53. EICHHORN TE, BRUNT E, OERTEL WH: Ondansetron treatment of L-dopa-induced psychosis. Neurology (1996) 47(6):1608-1609.
54. FACTOR SA, MOLHO ES, BROWN DL: Combined clozapine and electroconvulsive therapy for the treatment of drug-induced psychosis in Parkinson's disease. J. Neuropsychiatry Clin. Neurosci. (1995) 7(3):304-307.
55. PERRY RH, IRVING D, BLESSED G, FAIRBAIRN A, PERRY EK: Senile dementia of Lewy body type. A clinically and neuropathologically distinct form of Lewy body dementia in the elderly. J. Neurol. Sci. (1990) 95(2):119-139.
56. WEINER MF: Dementia associated with Lewy bodies: dilemmas and directions. Arch. Neurol. (1999) 56(12):1441-1442.
57. MCKEITH IG, DICKSON DW, LOWE J et al.: Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology (2005) 65(12):1863-1872.
58. MCKEITH IG: Dementia with Lewy bodies. Br. J. Psychiatry (2002) 180:144-147.
59. TIRABOSCHI P, HANSEN LA, ALFORD M et al.: Cholinergic dysfunction in diseases with Lewy bodies. Neurology (2000) 54(2):407-411.
60. BURN DJ, MCKEITH IG: Current treatment of dementia with Lewy bodies and dementia associated with Parkinson's disease. Mov. Disord. (2003) 18(Suppl.6):S72-79.
61. MCKEITH I, FAIRBAIRN A, PERRY R, THOMPSON P, PERRY E: Neuroleptic sensitivity in patients with senile dementia of Lewy body type. Br. Med. J. (1992) 305(6855):673-678.
62. AARSLAND D, BALLARD C, LARSEN JP, MCKEITH I: A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia. Int. J. Geriatr. Psychiatry (2001) 16(5):528-536.
63. KLATKA LA, LOUIS ED, SCHIFFER RB: Psychiatric features in diffuse Lewy body disease: a clinicopathologic study using Alzheimer's disease and Parkinson's disease comparison groups. Neurology (1996) 47(5):1148-1152.
64. MOSIMANN UP, ROWAN EN, PARTINGTON CE et al.: Characteristics of visual hallucinations in Parkinson's disease dementia and dementia with lewy bodies. Am. J. Geriatr. Psychiatry (2006) 14(2):153-160.
65. BALLARD CG, O'BRIEN JT, SWANN AG et al.: The natural history of psychosis and depression in dementia with Lewy bodies and Alzheimer's disease: persistence and new cases over 1 year of follow-up. J. Clin. Psychiatry (2001) 62(1):46-49.
66. BALLARD C, HOLMES C, MCKEITH I et al.: Psychiatric morbidity in dementia with Lewy bodies: a prospective clinical and neuropathological comparative study with Alzheimer's disease. Am. J. Psychiatry (1999) 156(7):1039-1045.
67. MCKEITH IG: Spectrum of Parkinson's disease, Parkinson's dementia, and Lewy body dementia. Neurol. Clin. (2000) 18(4):865-902.
68. MCKEITH I, DEL SER T, SPANO P et al.: Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet (2000) 356(9247):2031-2036.
69. WILD R, PETTIT T, BURNS A: Cholinesterase inhibitors for dementia with Lewy bodies. Cochrane Databane Syst. Rev. (2003) (3):CD003672.
70. GRACE J, DANIEL S, STEVENS T et al.: Long-term use of rivastigmine in patients with dementia with Lewy bodies: an open-label trial. Int. Psychogeriatr. (2001) 13(2):199-205.
71. SHEA C, MACKNIGHT C, ROCKWOOD K: Donepezil for treatment of dementia with Lewy bodies: a case series of nine patients. Int. Psychogeriatr. (1998) 10(3):229-238.
72. LANCTOT KL, HERRMANN N: Donepezil for behavioural disorders associated with Lewy bodies: a case series. Int. J. Geriatr. Psychiatry (2000) 15(4):338-345.
73. SAMUEL W, CALIGIURI M, GALASKO D et al.: Better cognitive and psychopathologic response to donepezil in patients prospectively diagnosed as dementia with Lewy bodies: a preliminary study. Int. J. Geriatr. Psychiatry (2000) 15(9):794-802.
74. CUMMINGS JL, STREET J, MASTERMAN D, CLARK WS: Efficacy of olanzapine in the treatment of psychosis in dementia with lewy bodies. Dement. Geriatr. Cogn. Disord. (2002) 13(2):67-73.
75. WALKER Z, GRACE J, OVERSHOT R et al.: Olanzapine in dementia with Lewy bodies: a clinical study. Int. J. Geriatr. Psychiatry (1999) 14(6):459-466.
76. BALDWIN SHAVERY E: Lewy body dementia. J. Miss. State Med. Assoc. (2002) 43(4):107-108.
77. ALLEN RL, WALKER Z, D'ATH PJ, KATONA CL: Risperidone for psychotic and behavioural symptoms in Lewy body dementia. Lancet (1995) 346(8968):185.
78. SHIWACH RS, WOODS S: Risperidol and withdrawal bruxism in Lewy body dementia. Int. J. Geriatr. Psychiatry (1998) 13(1):65-66.
79. GEIZER M, ANCILL RJ: Combination of risperidone and donepezil in Lewy body dementia. Can. J. Psychiatry (1998) 43(4):421-422.
80. KATO K, WADA T, KAWAKATSU S, OTANI K: Improvement of both psychotic symptoms and Parkinsonism in a case of dementia with Lewy bodies by the combination therapy of risperidone and L-DOPA. Prog. Neuropsychopharmacol. Biol. Psychiatry (2002) 26(1):201-203.
81. BALLARD C, GRACE J, MCKEITH I, HOLMES C: Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer's disease. Lancet (1998) 351(9108):1032-1033.
82. MCKEITH IG, BALLARD CG, HARRISON RW: Neuroleptic sensitivity to risperidone in Lewy body dementia. Lancet (1995) 346(8976):699.
83. SECHI G, AGNETTI V, MASURI R et al.: Risperidone, neuroleptic malignant syndrome and probable dementia with Lewy bodies. Prog. Neuropsychopharmacol. Biol. Psychiatry (2000) 24(6):1043-1051.
84. MORIKAWA M, KISHIMOTO T: Probable dementia with Lewy bodies and risperidone-induced delirium. Can. J. Psychiatry (2002) 47(10):976.
85. DAVIS P, BASKYS A: Quetiapine effectively reduces psychotic symptoms in patients with Lewy body dementia: an advantage of the unique pharmacological profile? Brain Aging (2002) 2(4):49-53.
86. FERNANDEZ HH, TRIESCHMANN ME, BURKE MA, FRIEDMAN JH: Quetiapine for psychosis in Parkinson's disease versus dementia with Lewy bodies. J. Clin. Psychiatry (2002) 63(6):513-515.
87. TAKAHASHI H, YOSHIDA K, SUGITA T, HIGUCHI H, SHIMIZU T: Quetiapine treatment of psychotic symptoms and aggressive behavior in patients with dementia with Lewy bodies: a case series. Prog. Neuropsychopharmacol Biol. Psychiatry (2003) 27(3):549-553.
88. TERAO T, SHIMOMURA T, IZUMI Y, NAKAMURA J: Two cases of quetiapine augmentation for donepezil-refractory visual hallucinations in dementia with Lewy bodies. J. Clin. Psychiatry (2003) 64( 12):1520-1521.
89. CHACKO RC, HURLEY RA, JANKOVIC J: Clozapine use in diffuse Lewy body disease. J. Neuropsychiatry Clin. Neurosci. (1993) 5(2):206-208.
90. GEROLDI C, FRISONI GB, BIANCHETTI A, TRABUCCHI M: Drug treatment in Lewy body dementia. Dement. Geriatr. Cogn. Disord. (1997) 8(3):188-197.
91. BURKE WJ, PFEIFFER RF, MCCOMB RD: Neuroleptic sensitivity to clozapine in dementia with Lewy bodies. J. Neuropsychiatry Clin. Neurosci. (1998) 10(2):227-229.
92. CRAUFURD D, THOMPSON JC, SNOWDEN JS: Behavioral changes in Huntington's disease. Neuropsychiatry Neuropsychol. Behav. Neurol. (2001) 14(4):219-226.
93. JENSEN P. SORENSEN SA, FENGER K, BOLWIG TG: A study of psychiatric morbidity in patients with Huntington's disease, their relatives, and controls. Admissions to psychiatric hospitals in Denmark from 1969 to 1991. Br. J. Psychiatry (1993) 163:790-797.
94. SHIWACH R: Psychopathology in Huntington's disease patients. Acta Psychiatr. Scand (1994) 90(4):241-246.
95. MARDER K, ZHAO H, MYERS RH et al.: Rate of functional decline in Huntington's disease. Huntington Study Group. Neurology (2000) 54(2):452-458.
96. PAULSEN JS, READY RE, HAMILTON JM, MEGA MS, CUMMINGS JL: Neuropsychiatric aspects of Huntington's disease. J. Neurol. Neurosurg. Psychiatry (2001) 71(3):310-314.
97. CANKURTARAN ES, OZALP E, SOYGUR H, CAKIR A: Clinical experience with risperidone and memantine in the treatment of Huntington's disease. J Natl Med. Assoc. (2006) 98(8):1353-1355.
98. ERDEMOGLU AK, BORATAV C: Risperidone in chorea and psychosis of Huntington's disease. Eur J. Neurol. (2002) 9(2):182-183.
99. MADHUSOODANAN S, BRENNER R: Use of risperidone in psychosis associated with Huntington's disease. Am. J. Geriatr. Psychiatry (1998) 6(4):347-349.
100. SAJATOVIC M, VERBANAC P, RAMIREZ LF, MELTZER HY: Clozapine treatment of psychiatric symptoms resistant to neuroleptic treatment in patients with Huntington's chores. Neurology (1991) 41(1): 156.
101. ALPAY M, KOROSHETZ WJ: Quetiapine in the treatment of behavioral disturbances in patients with Huntington's disease. Psychosomatics (2006) 47(1):70-72.
102. SEITZ DP, MILLSON RC: Quetiapine in the management of psychosis secondary to Huntington's disease: a case report. Can. J. Psychiatry (2004) 49(6):413.
103. PETRIKIS P, ANDREOU C, PIACHAS A, BOZIKAS VP, KARAVATOS A: Treatment of Huntington's disease with galantamine. Int. Clin. Psychopharmacol. (2004) 19(1):49-50.
104. EVANS DL, PEDERSEN CA, TANCER ME: ECT in the treatment of organic psychosis in Huntington's disease. Convuls. Ther. (1987) 3(2):145-150.