Dopamine agonists and creativity
A.J. Lees MD, FRCP, FRCP(Ed), FMedSci
The National Hospital, Queen Square, London WC1N 3BG, United Kingdom
Creativity is the process of producing something original and worthwhile that involves an act of imagination. The location of creative genius in the brain has fascinated neurologists and psychiatrists for more than a century. All of us are born with particular talents but it has been claimed that creative individuals may have more suppression of convergent thinking in the dominant hemisphere . Paradoxically some types of neurological damage that lead to learning and cognitive impairment can augment artistic abilities. There is also a particular linkage between bipolar disorder and artistic creativity, and it has even been suggested that the creation of art may be a compensatory behaviour to stave off psychosis .
Oral dopamine agonists drugs and to a lesser extent L-DOPA can increase impulsivity in about one in ten patients with Parkinson’s disease leading to disastrous behavioural consequences including an overuse of their medication , pathological gambling and compulsive sexual disorder. There are also a few patients in whom artistic talent flowers sometimes for the first time in their lives. In professional artists with Parkinson’s disease, the style and themes of their paintings may change, and writers and poets have commented on their increased productivity on medication. Some of these individuals have observed that attempting to increase these beneficial effects by taking more medication can lead to disruptive continuous meaningless stereotyped activity (punding) . An unresolved issue is whether the reported creativity in people with Parkinson’s disease is an epiphenomenon related to agonist-induced hypomania(5) or increased schizotypy . Apart from implicating excessive dopaminergic drive in the cerebral cortex as a possible cause for creativity these clinical observations also suggest that therapists should encourage artistic pastimes as well as physical exercise.
1. York GK. The Cerebral Localisation of Creativity. Rose FC, editor: Imperial College Press; 2004. pp1-11
2. Post F. Creativity and psychopathology. A study of 291 world-famous men. Br J Psychiatry 1994;165(1):22-34.
3. Giovannoni G, O'Sullivan JD, Turner K et al. Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000;68(4):423-8
4. Lhommée E, Batir A, Quesada JL et al. Dopamine and the biology of creativity: lessons from Parkinson's disease. Front Neurol 2014;5:55
5. Murphy DL, Goodwin FK, Brodie HK, Bunney WE Jr. L-dopa, dopamine, and hypomania. Am J Psychiatry 1973;130(1):79-82
6. Polner B, Nagy H, Takáts A, Keri S. Kiss of the Muse for the Chosen Ones: de novo schizotypal traits and lifetime creative achievement are related to changes in divergent thinking during dopaminergic therapy in Parkinson’s disease. Psychol Aesthet Creat Arts 2015;9(3):328-39.