Treatment with L-DOPA in Two Cases of Organic Brain Syndrome

(1) In both of the two cases associated with organic brain syndrome, which were presumably based on the frontal lobe damages, outstanding clinical improvements were observed by oral administration of L-DOPA, 200 to 400 mg daily. (2) Case 1 showed marked depressive symptoms, such as emotional weakness, depressive mood, autistic tendency, apathy and lack of spontaneity due to severe frontal lobe damage by an automobile accident. Treatment with L-DOPA improved his psychic symptoms. He acknowledged his thanks for the L-DOPA treatment by his words that he felt he had regained his former self. When the drug was withdrawn, psychotic symptoms reappeared. (3) Case 2, who was associated with depressive psychic symptoms after carbon monoxide poisoning and whose pneumoen-cepholographs indicated the presence of frontal lobe atrophy, showed remarkable elevation in his mood and in his activity level following administration of L-DOPA. Psychic alterations were most outstanding 14 to 15 days after the commencement of L-DOPA administration and the degree of elation tended to settle down corresponding to the decrease in the dosage. It can be concluded that L-DOPA is also potent in some cases of suppressed emotion due to organic brain damages. A decrease in stimulation from damaged frontal lobe projected to noradrenergic system of the hypothalamus may cause hypofunction of the system and subsequently reflect the state of hypotonic affective disturbance. Administration of L-DOPA may accelerate the synthesis of dopamine function to the normal level.