Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.1024
Peer-review started: May 31, 2021
First decision: October 16, 2021
Revised: November 3, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022
Othello syndrome (OS) is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner, which may lead to extreme behaviors. Impulse control disorders refer to behaviors involving repetitive, excessive, and compulsive activities driven by an intense desire. Both OS and impulse control disorders in Parkinson’s disease (PD) may be side effects of dopamine agonists. At present, there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.
We describe a 70-year-old male patient with PD, OS, and impulse control disorders, who presented with a six-month history of the delusional belief that his wife was having an affair with someone. He began to show an obvious increase in libido presenting as frequent masturbation. He had been diagnosed with PD ten years earlier and had no past psychiatric history. In his fourth year of PD, he engaged in binge eating, which lasted approximately one year. Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.
Given its potential for severe consequences, OS should be identified early, especially in patients undergoing treatment with dopamine agonists.
Core Tip: Both Othello syndrome (OS) and impulse control disorders in Parkinson’s disease (PD) may be considered side effects of dopamine agonist therapy. These syndromes may have severe consequences; thus, when clinical features of either syndrome appear, the features of both syndromes should be investigated further. We report the case of a patient with PD, OS, hypersexuality, and binge eating. The syndrome was alleviated after a reduction of the patient’s pramipexole dosage and the addition of quetiapine.