Dopamine inhibition and the adaptation of behavior to ongoing reality.

Spontaneous confabulation is a rare memory disorder resulting from orbitofrontal damage or disconnection. Patients act on the basis of memories that do not pertain to the current situation, and are disoriented. No medical treatment is known. Recent studies suggest that subcortical dopaminergic structures are involved in the selection of currently relevant memories. We present a patient who regained the ability to adapt thought and behavior to ongoing reality when treated with risperidone, a dopamine antagonist.