Difference between revisions of "Dopamine dysregulation syndrome (DDS)"

(Created page with "'''Diagnosis''' Dopamine dysregulation syndrome (DDS) is an uncommon complication in the treatment of PD, characterized by addictive behavior and excessive use of dopaminergi...")
 
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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 110
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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)
  
* prevalence is 3-4% in movement disorder clinics 110
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* prevalence is 3-4% in movement disorder clinics (Warren et al, 2017)
* can result in impulse control disorders and psychosis 110
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* can result in impulse control disorders and psychosis (Warren et al, 2017)
* Clinical characteristics include:
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* 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%)
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** dysthymic / depressed mood (62.2%)
 
** dysthymic / depressed mood (62.2%)
 
** anxiety (37.8%)
 
** anxiety (37.8%)
** dyskinesias (79.6%) 110
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** dyskinesias (79.6%)  
* comorbidities include  
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* comorbidities include (Warren et al, 2017)
 
** punding (21.4%)
 
** punding (21.4%)
 
** aggression (17.3%)
 
** aggression (17.3%)
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** gambling (27.6%)
 
** gambling (27.6%)
 
** hypersexuality (39.8%)
 
** hypersexuality (39.8%)
** compulsive shopping (8.2%) 110
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** compulsive shopping (8.2%)  
  
  
 +
'''Treatment''' (Warren et al, 2017)
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 +
* DRT regime change (improvement in 25/52 cases)
 +
* Psychological therapy (improvement in 4/7 cases)
 +
* Electroconvulsive therapy (improvement in 0/1 cases)
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* Antidepressants (improvement in 3/9 cases)
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* Antipsychotics (improvement in 6/11 cases)
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* Valproic acid (improvement in 5/5 cases)
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* Lithium (improvement in 0/2 cases)
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* Levodopa infusion (improvement in 4/8 cases)
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* Apomorphine infusion (improvement in 0/2 cases)
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* Deep brain stimulation (improvement in 7/12 cases)
  
 
== References ==
 
== References ==
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 +
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/