|
Abstract
|
Oscar Wilde defined a writer as "someone who has taught their mind to misbehave." Creativity has remained a mystery. Herein, we present the case of a patient who developed a passion for poetry after Parkinson disease (PD) treatment. This passion intensified after bilateral subthalamic nucleus deep brain stimulation (DBS).
A 62-year-old married man with no psychiatric history presented to our emergency department (ED) after attempting suicide by wrist-cutting. Before receiving a PD diagnosis in 2016, he had worked as a salesman and had been treated with levodopa, selegiline, rotigotine, and entacapone. Apart from briefly joining a university literary club over 40 years earlier, he had minimal writing experience. One year after his diagnosis, he started sharing his poems on social media.
In March 2020, his medications were adjusted because of deteriorating symptoms. He was hospitalized in August 2020 for dopaminergic-therapy-induced persecutory delusions. Quetiapine 100 mg daily was added postdischarge but was discontinued 3 months later because of an improvement in his condition. In September 2021, he underwent bilateral subthalamic nucleus DBS (Abbott Infinity 6662). His daily medications preoperatively included Madopar 1000 mg, selegiline 10 mg, rotigotine 6 mg, and entacapone 1000 mg (levodopa equivalent dosage: 1580 mg); his Beck Depression Inventory-Second Edition score was 2/63. His motor function improved postoperatively; his medication regimen was thus simplified to levodopa 100 mg, carbidopa 25 mg, and entacapone 200 mg five times daily. In March 2022, his post-DBS programming evoked a satisfactory motor response∗; he started writing poems prolifically and even successfully published them. Although his family reported heightened sensitivity, negative associations, and occasional dysthymic moods, postoperative assessments revealed no major neurocognitive or behavioral problems. However, he experienced a severe and sudden decline in mood, which prompted his suicide attempt and was associated with perceived inadequacy in fulfilling familial obligations, as expressed during his ED visit. Throughout the PD treatment course, no manic symptoms were observed.
According to research, creativity in patients with PD is linked to dopamine agonist therapy and tends to decrease post- DBS because of reduced dopamine agonist use.1 However, DBS may positively affects artistic endeavors among some patients with PD...
Language: en |