Difference between revisions of "Dopamine dysregulation syndrome (DDS)"
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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) | 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) | * Clinical characteristics include: (Warren et al, 2017) | ||
** responsiveness to levodopa (100%) | ** responsiveness to levodopa (100%) | ||
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** anxiety (37.8%) | ** anxiety (37.8%) | ||
** dyskinesias (79.6%) | ** dyskinesias (79.6%) | ||
| − | * | + | * Comorbidities include (Warren et al, 2017) |
** punding (21.4%) | ** punding (21.4%) | ||
** aggression (17.3%) | ** aggression (17.3%) | ||
Latest revision as of 11:59, 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/
