Difference between revisions of "Dopamine dysregulation syndrome (DDS)"
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'''Diagnosis''' | '''Diagnosis''' | ||
| − | Dopamine dysregulation syndrome (DDS) is an uncommon complication in the treatment of PD, characterized by addictive behavior and excessive use of dopaminergic medication | + | Dopamine dysregulation syndrome (DDS) is an uncommon complication in the treatment of PD, characterized by addictive behavior and excessive use of dopaminergic medication (Warren et al, 2017) |
| − | * prevalence is 3-4% in movement disorder clinics | + | * prevalence is 3-4% in movement disorder clinics (Warren et al, 2017) |
| − | * can result in impulse control disorders and psychosis | + | * can result in impulse control disorders and psychosis (Warren et al, 2017) |
| − | * Clinical characteristics include: | + | * Clinical characteristics include: (Warren et al, 2017) |
** responsiveness to levodopa (100%) | ** responsiveness to levodopa (100%) | ||
** increased dopamine replacement therapy dose used (100%) | ** increased dopamine replacement therapy dose used (100%) | ||
| Line 13: | Line 13: | ||
** dysthymic / depressed mood (62.2%) | ** dysthymic / depressed mood (62.2%) | ||
** anxiety (37.8%) | ** anxiety (37.8%) | ||
| − | ** dyskinesias (79.6%) | + | ** dyskinesias (79.6%) |
| − | * comorbidities include | + | * comorbidities include (Warren et al, 2017) |
** punding (21.4%) | ** punding (21.4%) | ||
** aggression (17.3%) | ** aggression (17.3%) | ||
| Line 22: | Line 22: | ||
** gambling (27.6%) | ** gambling (27.6%) | ||
** hypersexuality (39.8%) | ** hypersexuality (39.8%) | ||
| − | ** compulsive shopping (8.2%) | + | ** compulsive shopping (8.2%) |
| + | '''Treatment''' (Warren et al, 2017) | ||
| + | |||
| + | * DRT regime change (improvement in 25/52 cases) | ||
| + | * Psychological therapy (improvement in 4/7 cases) | ||
| + | * Electroconvulsive therapy (improvement in 0/1 cases) | ||
| + | * Antidepressants (improvement in 3/9 cases) | ||
| + | * Antipsychotics (improvement in 6/11 cases) | ||
| + | * Valproic acid (improvement in 5/5 cases) | ||
| + | * Lithium (improvement in 0/2 cases) | ||
| + | * Levodopa infusion (improvement in 4/8 cases) | ||
| + | * Apomorphine infusion (improvement in 0/2 cases) | ||
| + | * Deep brain stimulation (improvement in 7/12 cases) | ||
== References == | == References == | ||
| + | |||
| + | Warren, N., O’Gorman, C., Lehn, A. & Siskind, D. Dopamine dysregulation syndrome in Parkinson’s disease: a systematic review of published cases. J. Neurol. Neurosurg. Psychiatry 88, 1060–1064 (2017). https://pubmed.ncbi.nlm.nih.gov/29018160/ | ||
Revision as of 11:58, 12 June 2021
Diagnosis
Dopamine dysregulation syndrome (DDS) is an uncommon complication in the treatment of PD, characterized by addictive behavior and excessive use of dopaminergic medication (Warren et al, 2017)
- prevalence is 3-4% in movement disorder clinics (Warren et al, 2017)
- can result in impulse control disorders and psychosis (Warren et al, 2017)
- Clinical characteristics include: (Warren et al, 2017)
- responsiveness to levodopa (100%)
- increased dopamine replacement therapy dose used (100%)
- drug-seeking behavior (91.8%)
- functional impairment (98%)
- hypomanic / manic / cyclothymic mood (64.3%)
- dysthymic / depressed mood (62.2%)
- anxiety (37.8%)
- dyskinesias (79.6%)
- comorbidities include (Warren et al, 2017)
- punding (21.4%)
- aggression (17.3%)
- psychosis (31.6%, mostly delusions)
- walkabout (11.2%)
- binge eating (10.2%)
- gambling (27.6%)
- hypersexuality (39.8%)
- compulsive shopping (8.2%)
Treatment (Warren et al, 2017)
- DRT regime change (improvement in 25/52 cases)
- Psychological therapy (improvement in 4/7 cases)
- Electroconvulsive therapy (improvement in 0/1 cases)
- Antidepressants (improvement in 3/9 cases)
- Antipsychotics (improvement in 6/11 cases)
- Valproic acid (improvement in 5/5 cases)
- Lithium (improvement in 0/2 cases)
- Levodopa infusion (improvement in 4/8 cases)
- Apomorphine infusion (improvement in 0/2 cases)
- Deep brain stimulation (improvement in 7/12 cases)
References
Warren, N., O’Gorman, C., Lehn, A. & Siskind, D. Dopamine dysregulation syndrome in Parkinson’s disease: a systematic review of published cases. J. Neurol. Neurosurg. Psychiatry 88, 1060–1064 (2017). https://pubmed.ncbi.nlm.nih.gov/29018160/
