[rose of his heart]

Now I'm no Desdemona, BA or OA (Before Agonists or On Agonists), so I was surprised to begin having chronic, tedious suspicions/obsessions (though not quite delusions) of infidelity in my relationship. Apparently, I am not alone; the phenomenon even has an evocative name: Othello's Syndrome!!! What did surprise me was that these suspicions upset me. I was never the "jealous type," and rather open-minded about relationship structures. So what gives?

Am I growing up, or growing old? Am I reverting to the mores of my childhood years, a swinging back of the pendulum? Is it really the agonist therapy? Or, as my mother says, "just because you're paranoid doesn't mean someone isn't out to get you," implying the existence of an affair. (Thanks, mom.) Or is it that, with all the physical changes PD brings, I am for the first time insecure and uncomfortably dependent on my partner? I've read that cessation of agonist therapy is indicated with Othello's Syndrome. Any thoughts, experience or advice out there today? Have you been through anything like this?

BTW, there's some research floating around on this of late: search "othello's syndrome" and parkinson's. Here's one abstract:

OTHELLO SYNDROME IN PATIENTS WITH PARKINSON'S DISEASE
Dejan Georgiev, Aljoša Danieli, Lidija Ocepek, Dominika Novak, Nina Zupančič-Križnar, Maja Trošt & Zvezdan Pirtošek Department of Neurology, University Medical Centre Ljubljana, Slovenia
SUMMARY Background: Othello syndrome (OS) is an organic delusional disorder with prevailing jealousy symptoms presumably appearing
as side effect of antiparkinsonian therapy. The clinical spectrum of psychiatric symptoms in Parkinson's disease (PD) is very wide, including symptoms of depresion and anxiety, hallucinations, delusions, with prevalent paranoid symptoms, agitation, delirium and sleep disorders. At our knowledge, just a few cases of patients with PD and OS were reported till now.
Methods: three neurologists working in a tertiary referral centre were asked to report cases of pathological jealousy as defined by the DSM IV criteria (Kaplan et al. 1994). The following data were collected retrospectively: sex, age at PD onset, age at OS onset, duration of PD, duration of PD treatment, duration of treatment with dopamine agonists (DAs), treatment of OS, past history of alcoholism, premorbid personality disorder, family history of psychiatric disorders and data about general cognitive condition.
Results: Five PD patients (three males) with OS were investigated. The mean age of the patients at the PD onset was 46.80±8.87 (SD), the mean age at the OS onset was 56.40±8.76 (SD). Before the onset of OS, all of them were taking dopamine agonists. The first patient was treated with pramipexole, apomorphine infusion and levodopa/carbidopa, the second with apomorphine infusion plus levodopa/carbidopa/entacapone, the third with pramipexole, the fourth and fifth with ropinirole. Decrease of dopamine agonist led to clinical improvement in three patients (complete reduction of the symptoms in two, reduction of symptoms in one patients). In two patients, the symptoms remained the same. In three patients atypical neuroleptics had to be added: clozapine in two and quetiapine in one patient.
Conclusions: We believe that OS is a more common psychiatric side effect in PD patients on treatment with dopamine agonists than usually believed, particulary in those with early disease onset. It is a very disturbing symptom for patients and their partners, often underestimated by them, and should therefore be actively searched for.

[Bob Dawson]

Originally Posted by rose of his heart;724801............I was surprised to begin having chronic, tedious suspicions/obsessions (though not quite delusions) of [B

infidelity[/B] in my relationship. Apparently, I am not alone; the phenomenon even has an evocative name: Othello's Syndrome!!! What did surprise me was that these suspicions upset me. I was never the "jealous type," and rather open-minded about relationship structures. So what gives?

Am I growing up, or growing old? Am I reverting to the mores of my childhood years, a swinging back of the pendulum? Is it really the agonist therapy? Or, as my mother says, "just because you're paranoid doesn't mean someone isn't out to get you," implying the existence of an affair. (Thanks, mom.)

BTW, there's some research floating around on this of late: search "othello's syndrome" and parkinson's. Here's one abstract:

SUMMARY Background: Othello syndrome (OS) is an organic delusional disorder with prevailing jealousy symptoms presumably appearing
... The clinical spectrum of psychiatric symptoms in Parkinson's disease (PD) is very wide, including symptoms of depression and anxiety, hallucinations, delusions, with prevalent paranoid symptoms, agitation, delirium and sleep disorders.

...It is a very disturbing symptom for patients and their partners, often underestimated by them, and should therefore be actively searched for.

POWERFUL POST from Rose of His Heart. I don't think it is just paranoia about sexual or marital infidelity. I think it extends to difficulty in trusting lots of people; paranoia about what people are saying or scheming. It helps a lot if you can talk about it to the friend in question, but it is delicate and explosive, because it's like accusing someone of infidelity and they can deny it, etc.,
I told one person that I am paranoid about two things -
(1) his betrayal of my trust and friendship, and
(2) I am being followed by lobsters.

I am not sure about my cognition in (2), but all my instincts are claiming the validity or (1) and it hurts. Betrayal hurts. But the friend says it doesn't sound like him and I say I am sorry but oh yes it does.
And then I can relieve the tension by holding the door open for my lobsters.
It's live theater to win back a friend lost to PD

[imark3000]

Originally Posted by Bob Dawson

POWERFUL POST from Rose of His Heart. I don't think it is just paranoia about sexual or marital infidelity. I think it extends to difficulty in trusting lots of people; paranoia about what people are saying or scheming. It helps a lot if you can talk about it to the friend in question, but it is delicate and explosive, because it's like accusing someone of infidelity and they can deny it, etc.,
I told one person that I am paranoid about two things -
(1) his betrayal of my trust and friendship, and
(2) I am being followed by lobsters.

I am not sure about my cognition in (2), but all my instincts are claiming the validity or (1) and it hurts. Betrayal hurts. But the friend says it doesn't sound like him and I say I am sorry but oh yes it does.
And then I can relieve the tension by holding the door open for my lobsters.
It's live theater to win back a friend lost to PD

Bob, Rose
Good to hear you ..
My 2cent (as you say in English!):
What the heak, I have your feelings every now and then. The possibiliy of disappointment, betrayal, loss of love, being misunderstood, being bored or boring, etc. etc, exists in any human relationship, no matter how solid it may look, with or without PD. Nothing is certain in our shayki existence. We take the risk and go on. and yes I have my lobsters too.
regards
Imad

[Conductor71]

Rose,

Thank you for unveiling this fascinating connection. I had read a bit about it sometime ago, and you bringing it up now is great timing. It is slowly sinking in that Parkinson's has stolen most of my adult life, including my sense of who I was. Maybe there is no real sense of being this whole person, maybe we are constantly in a state of flux, and to think other wise is an illusion. Although 43 years in,, and I still can't remember to pick up my clothes off the floor.

I think back to the years just preceding my shaky hand. I was in a constant state of anxiety; I began having social phobia for the first time ever...all of it seemed to appear out of nowhere. However, I have come to realize it did have a partner in crime...that would be Parkinson's. Researchers are now just starting to recognize the serious nature of depression in PD, yet even fewer are looking at anxiety. They are even beginning to assemble a clinical "profile" of the anxious PWP.

- They have YOPD
-They tend toward social phobia and anxiety to panic disorder over symptoms (this is my recent welcome into the world of freezing).
-Most often women

However, most studies look at anxiety after the fact, and I am saying for me it was a calling card. It looks like that is the case for many others:

This study contributes to the growing body of literature examining the role that psychiatric disorders may play prior to PD motor symptom onset. There is evidence of a prodromal phase in PD from imaging, pathology, and clinical, epidemiological, and animal studies [11], [30], [31], [32]. Estimates of duration of the prodromal period vary widely, from 3 up to 20 years, and symptoms can include olfaction deficits, dysautonomia, and sleep and psychiatric disorders[11], [30], [32]. While we assumed an average duration of 5 years for prodromal symptoms in this study, age and disease etiology may be important factors determining the actual length of this phase [11], [30], [32]. Although the pathophysiology of depression and anxiety in pre-clinical PD is not fully understood, [33] its basis may be noradrenergic, dopaminergic or serotonergic [34], [35] and the neurologic structures involved may included the substantia nigra or coeruleus/subcoeruleus complex, where dysfunction occurs in Braak Stage 2, and has been estimated to begin ten years or more prior to motor symptoms.

"Occurrence of Depression and Anxiety in PD" Parkinsonism & Related Disorders. November 2010

Bob,

Thank you for that visual of lobsters following you. I recently told a psychiatrist who inquired about phobia that I had a fear of lobsters but really it was an homage to one of my favorite film directors, Woody Allen. I had happened to have watched Annie Hall the night before. They never make it far enough to have Othello Syndrome, but leave us laughing and thinking lobsters.