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dc.contributor.authorWarren, Nicola
dc.contributor.authorO'Gorman, Cullen
dc.contributor.authorLehn, Alexander
dc.contributor.authorSiskind, Dan
dc.date.accessioned2021-04-22T04:45:50Z
dc.date.available2021-04-22T04:45:50Z
dc.date.issued2017
dc.identifier.issn0022-3050
dc.identifier.doi10.1136/jnnp-2017-315985
dc.identifier.urihttp://hdl.handle.net/10072/403901
dc.description.abstractObjectives Dopamine dysregulation syndrome (DDS) is an uncommon complication of the treatment of Parkinson's disease, characterised by addictive behaviour and excessive use of dopaminergic medication. DDS may frequently go unrecognised or misdiagnosed. We aimed to clarify current understanding of presentation, risk factors, comorbidities and management of DDS. Methods Case reports were identified through a systematic search of databases (PubMed, Embase) with the following terms: dopaminergic dysregulation syndrome, hedonistic homeostatic dysregulation, dopamine/levodopa addiction. Results We reviewed 390 articles, identifying 98 cases of DDS. Early-onset Parkinson's disease (67%) and male gender (83%) were common. DDS presented with significant physical and social impairment, actions to enable or prevent detection of overuse, as well as mood, anxiety and motor fluctuations. All DDS cases met DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) substance use disorder criteria. Past substance and psychiatric history was present in 15.3% and 10.2% of cases. Comorbid impulse control disorders (61%), psychosis (32%) and panic attacks (14%) were common. A large variety of management strategies were used; only 56% of cases resolving. Sodium valproate was successful in 5/5 cases. The response to deep brain stimulation varied. Conclusions Given the functional impairment, medical and psychiatric consequences and the difficulties of treatment, early identification of DDS should be a priority.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.relation.ispartofpagefrom1060
dc.relation.ispartofpageto1064
dc.relation.ispartofissue12
dc.relation.ispartofjournalJournal of Neurology, Neurosurgery & Psychiatry
dc.relation.ispartofvolume88
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode52
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsClinical Neurology
dc.subject.keywordsPsychiatry
dc.subject.keywordsSurgery
dc.titleDopamine dysregulation syndrome in Parkinson's disease: a systematic review of published cases
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationWarren, N; O'Gorman, C; Lehn, A; Siskind, D, Dopamine dysregulation syndrome in Parkinson's disease: a systematic review of published cases, Journal of Neurology, Neurosurgery & Psychiatry, 2017, 88 (12), pp. 1060-1064
dcterms.dateAccepted2017-08-01
dc.date.updated2021-04-22T03:36:58Z
gro.hasfulltextNo Full Text
gro.griffith.authorO'Gorman, Cullen


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