BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1396 (Published 27 August 2008) Cite this as: BMJ 2008;337:a1396

Any number of observational studies have shown that people who take regular exercise are less likely to be anxious or depressed. Although it’s tempting to think that there might be a causal relation here, findings in a large twin study from the Netherlands point the other way. In genetically identical twin pairs, the twin who exercised less was not more likely to report symptoms of anxiety and depression than the twin who exercised more (Archives of General Psychiatry 2008;65:897-905, http://archpsyc.ama-assn.org).

“Suddenly I saw a small coloured elephant underneath a wooden chair. It grew bigger and bigger, its trunk grew out to reach the leg of the table and I had the feeling the table was shaking.” This is how a patient with Parkinson’s disease described one of her hallucinations, which are common in this condition, especially when the patient is taking dopamine agonists or L-dopa. Treatment may be needed if the hallucinations are unpleasant or frightening or the patient lacks insight into them. Atypical antipsychotics should probably be the first choice (Practical Neurology 2008;8:238-41, doi: 10.1136/jnnp.2008.152579 …

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