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Observations placeholder

Oliver Sacks - L-DOPA, Parkinson's, Tourette's and mania



Type of Spiritual Experience

Invisible input - inspiration

Number of hallucinations: 1


If spiritual experience is sought continuously or frequently, it can so knock our balance that we become the ever open door.  We can’t stop having a spiritual experience.  Schizophrenics have an ever open door, as do voice hearers.  Frequent heavy drug users may flip themselves into this state.  Oliver Sacks found that in treating patients with the privations of all things spiritual caused by akinesia, aboulia, adynamia, anergia and so on with L-Dopa, he completely flipped them the other way and opened the door almost permanently.  Constant composer input can be almost impossible to handle…

On reading this you may also be struck with the similarity of the account of what happens to an overdosed L-Dopa patient or a Tourette syndrome patient and the phase of mania experienced by the manic depressive.  And I believe that in doing so you would be right. Tourette patients display many of the characteristics of the manic person.

And we see a similar situation with people having Parkinson’s disease also being treated with L-Dopa.  Without the L-Dopa their door to spiritual input is shut, with the L-Dopa it opens, but because getting the dose right is so difficult and absolutely key, the door can be opened so wide and so permanently the Parkinsonian patient ends up manic or like a Tourette patient or like the ‘Awakenings’patients of Dr Sacks.


L-DOPA is a chemical that is made and used as part of the normal biology of humans, some animals and plants. Some animals and humans make it via biosynthesis from the amino acid L-tyrosine. L-DOPA is the precursor to the neurotransmitters dopamine, norepinephrine (noradrenaline), and epinephrine (adrenaline) collectively known as catecholamines. L-DOPA can be manufactured and in its pure form is sold as a psychoactive drug with the INN levodopa; trade names include Sinemet, Parcopa, Atamet, Stalevo, Madopar, and Prolopa. As a drug, it is used in the clinical treatment of Parkinson's disease and dopamine-responsive dystonia.

L-DOPA crosses the protective blood–brain barrier, whereas dopamine itself cannot.

Oliver Sacks used L-DOPA and administered it to catatonic patients who survived the 1917–28 epidemic of encephalitis lethargica.


A description of the experience

The Man who mistook his wife for a hat – Oliver Sacks

Thus Rose R, in the first rush and joy of restored health, said ‘It’s fabulous, it’s gorgeous!’ but as things accelerated towards uncontrol said ‘Things can’t last.  Something awful is coming’.  And similarly, with more or less insight in most of the others – as with Leonard L as he passed from repletion to excess; ‘his abundance of health and energy – of ‘grace’ as he called it – became too abundant, and started to assume an extravagant form.  His sense of harmony and ease and effortless control was replaced by a sense of too-muchness … a great surplus a great pressure of … every kind, which threatened to disintegrate him, to burst him asunder.

This is the simultaneous gift and affliction, the delight, the anguish, conferred by excess.  And it is felt, by insightful patients, as questionable and paradoxical.  ‘I have too much energy’ one Tourette patient said ‘Everything is too bright, too powerful, too much.  It is a feverish energy, a morbid brilliance’

‘Dangerous wellness’,’ morbid brilliance’, a deceptive euphoria with abysses beneath – this is the trap promised and threatened by excess, whether it be set by nature, in the form of some intoxicating disorder, or by ourselves in the form of some excitant addiction.


The drawings of patients with Parkinsonism, as they are awakened by L-Dopa, form an instructive analogy.  Asked to draw a tree, the Parkinsonian tends to draw a small, meagre thing, stunted, impoverished, a bare winter tree with no foliage at all.  As he ‘warms up’, ‘comes to’, is animated by L-Dopa, so the tree acquires vigour, life, imagination – and foliage.  If he becomes too excited, high on L-Dopa, the tree may acquire a fantastic ornateness and exuberance, exploding with a florescence of new branches and foliage with little arabesques, curlicues and what not until finally, its original form is completely lost beneath this enormous, this baroque, elaboration.  Such drawings are also rather characteristic of Tourette’s – the original form, the original thought, lost in a jungle of embellishment – and in the so-called ‘speed-art’ of amphetiminism.  First the imagination is awakened, then excited, frenzied to endlessness and excess

The source of the experience

Sacks, Oliver

Concepts, symbols and science items




Science Items

Blood brain barrier

Activities and commonsteps