A Man With Persistent Dopamine Agonist Withdrawal Syndrome After 7 Years Being Off Dopamine Agonists

Huynh, Niem Tu; Sid-Otmane, Lamia; Panisset, Michel

doi:10.1017/cjn.2015.389

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…DAWS is a disabling complication related to DA tapering which encompasses a severe stereotypical cluster of psychiatric and psychological symptoms, such as anxiety, agitation, depression and drug craving, causing clinically significant distress or social/occupational dysfunction, very similar to those observed in patients with rasagiline withdrawal, and strongly linked with ICDs [ 2 , 3 ]. In a subset of patients, DAWS may be an unremitting condition whether therapy with dopamine agonists is maintained or not (even after several years) [ 12 ]. Previous studies have suggested that the major determinant of the development of DAWS may be the individual tendency to develop ICD in response to exposure to any DA, rather than other treatment or demographic factors [ 2 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

Rasagiline Withdrawal Syndrome in Parkinson’s Disease

et al. 2022

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Parkinson’s disease (PD) patients using dopamine agonists can develop withdrawal symptoms, referred to as dopamine agonist withdrawal syndrome (DAWS), under dose tapering or discontinuation of these drugs. DAWS includes a severe stereotypical cluster of psychiatric and psychological symptoms encompassing severe mood and anxiety disturbances, autonomic symptoms, as well as generalized pain and drug cravings. However, symptoms of withdrawal of dopamine replacement therapies (DRT) are not simply limited to dopamine agonists tapering, as observed in PD patients on deep brain stimulation after dopaminergic drugs withdrawal related to surgery. To date, no DRT-related withdrawal syndrome has been described in PD patients who discontinue rasagiline, an irreversible inhibitor of monoamine oxidase-B (MAO-B). Here we report three PD patients who developed a severe withdrawal syndrome after rasagiline suspension. The syndrome was mainly characterized by prominent psychiatric disorders (depression, anxiety with panic attacks, dysphoria, and agitation) associated with fatigue, generalized pain, and autonomic manifestations (closely resembling symptoms of DAWS). In our opinion, this report suggests the importance of closely monitoring PD patients undergoing rasagiline suspension for withdrawal symptoms and provides interesting points of reflection on the role of rasagiline and other MAO-B inhibitors in mood disorders.

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Section: Discussionmentioning

confidence: 99%

Rasagiline Withdrawal Syndrome in Parkinson’s Disease

et al. 2022

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“…DAWS is a condition that remains relatively poorly understood, despite being increasingly recognised, and consists of symptoms reminiscent of addictive drug withdrawal, 5 which may last for several years. 3,6 A previous case reported a PD patient committing suicide after discontinuation of the dopamine agonist pramipexole because of severe ICD. 7 Another case described a PD patient committing suicide while on levodopa/carbidopa intestinal gel infusion; we note that apomorphine infusion had been discontinued a few months before he ended his life.…”

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confidence: 99%