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Bromocriptine, physostigmine, and neurotransmitter mechanisms in the dystonias

Mental Health Clinical Research Center, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, and the Schizophrenia Biologic Research Center, Veterans Administration Medical Center, Palo Alto, CA.

We studied eight patients with different types of dystonia by administering agonists and antagonists of acetylcholine (ACh) and dopamine (DA). In all seven patients who received physostigmine, there was an exacerbation of the dystonia. All six patients who received anticholinergic agents improved, as did five of eight who received bromocriptine. Neuroleptics worsened symptoms in four patients with generalized dystonia and improved symptoms in one patient with Meige syndrome. Our results suggest that DA-ACh imbalance may underlie the pathophysiology of dystonia in some patients and that bromocriptine may be effective in treating these patients.

Address correspondence and reprint requests to Dr. Stahl, Mental Health Clinical Research Center, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305.

This research was supported by a Barbra Streisand Fellowship for Dystonia Research from the Dystonia Medical Research Foundation, by the Medical Research Service of the Veterans Administration, by NIMH Specialized Research Center Grant No. MH 30854, by NIH General Clinical Research Center Grant No. RR70, and by the Veterans Administration Schizophrenia Biologic Research Center.

Accepted for publication January 7, 1982.

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