Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease

Evans, Andrew; Lawrence, Andrew David; Potts, Jim; Appel, Silke; Lees, Andrew J.

doi:10.1212/01.wnl.0000184487.72289.f0

Cited by 194 publications

(187 citation statements)

References 30 publications

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“…The DDS, initially named hedonistic homeostatic dysregulation, is the overuse of dopaminergic drugs beyond that needed to relieve motor signs and in spite of the consequent disabling dyskinesias and behavioral disorders. The diagnostic criteria for DDS were defined by Pezzella et al 59 Risk factors associated with DDS are similar to the ones associated with ICDs 60 . There is usually a long latency between the beginning of levodopa treatment and the onset of drug misuse, and fast acting drugs are more likely associated with DDS 61 .…”

Section: Impulse Control Disorders and Dopamine Dysregulation Syndromementioning

confidence: 99%

Neuropsychiatry of Parkinson's disease

Kümmer

Teixeira

2009

Arq. Neuro-Psiquiatr.

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-Parkinson's disease (PD) is traditionally regarded as a movement disorder. In recent years, however, non-motor symptoms have been considered significant factors of disability at all stages of the illness. Behavioral and psychological symptoms or neuropsychiatric syndromes associated with PD are frequent and may represent a challenge in the management of these patients. They include anxiety, depression, psychosis, sleep, sexual and impulse control disorders, apathy and cognitive dysfunction. Their pathogenesis in PD is complex, involving neurodegenerative, drug-related and psychological mechanisms. We will review the current knowledge of this growing field, also focusing on the management of theses syndromes.KEY WORDS: Parkinson's disease, neuropsychiatry, psychology, psychiatric disorders. Neuropsiquiatria da doença de ParkinsonResumo -A doença de Parkinson (DP) é tradicionalmente conhecida como um distúrbio do movimento. Entretanto, os sintomas não-motores têm sido considerados recentemente como fatores relevantes de incapacidade em todos os estágios da doença. Sintomas motores e comportamentais ou síndromes neuropsiquiátricas associadas à DP são frequentes e seu manejo pode se tornar um verdadeiro desafio. São comuns quadros de ansiedade, depressão, psicose, distúrbios do sono, transtornos do controle do impulso, apatia e disfunções cognitivas. A patogênese desses transtornos na DP é complexa, envolvendo mecanismos degenerativos, psicológicos e relacionados ao tratamento. Neste artigo, revisamos o estado do conhecimento desse campo de interesse crescente, também enfocando o manejo dessas síndromes. PALAVRAS-CHAVE: doença de Parkinson, neuropsiquiatria, psicologia, transtornos psiquiátricos.

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Section: Impulse Control Disorders and Dopamine Dysregulation Syndromementioning

confidence: 99%

Neuropsychiatry of Parkinson's disease

Kümmer

Teixeira

2009

Arq. Neuro-Psiquiatr.

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“…Extra-striatal dopaminergic changes [11] and altered ventral striatal dopamine synthesis capacity [12,13] have now been observed in people with PD and ICDs, with the latter finding being a predictor of financial extravagance [12]. Dopamine replacement therapy is likely a key precipitant in the development of ICDs, however, several intrinsic risk factors such as higher propensity for "novelty-seeking" [14,15] may also be implicated. Other risk factors include: smoking status, male gender, younger age and younger age of disease onset, co-morbid or previous psychiatric symptoms, previous history of substance abuse, family and personal history of substance and behavioural addictions [2,10,[16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Personality Style in Behavioural Disturbances in Parkinson?s Disease

McDonald¹

2014

J Neurol Neurophysiol

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Objective: Non-motor changes in Parkinson's disease (PD) can include behavioural disturbances, such as apathy and impulse control disorders (ICDs). These behavioural problems impact on quality of life and caregiver burden. In the case of impulsivity, there is some association with specific personality styles at the time of assessment. This study compares current and pre-morbid personality attributes among people with PD who experience a clinically significant ICD, apathy, or no behavioural disturbance.Methods: 94 PD participants without dementia (ICD, n=34; apathy, n=24; control, n=36) were examined for current and pre-morbid (10 years before PD onset) personality style using self-and informant-versions of the NEO FiveFactor Inventory. All informants were knowledgeable about participants' midlife personalities and provided both current and pre-morbid ratings.Results: When key co-variates (depression, anxiety, age and dopamine load) were controlled for, a difference in self-reported current personality style was found among the three PD groups, with the ICD group rating themselves as less agreeable compared to those with apathy or no behavioural disorder. Informant-rated current and pre-morbid measurements of personality style did not differ. Conclusion:While people with PD and clinically significant ICDs currently report themselves as being less agreeable, their informants did not support this finding and reported no change from pre-morbid personality. Differences in personality style with impulsive-compulsive behaviours in PD may not be discernable to others and may be related to transient 'state' factors (i.e. influenced by the disease process or response to treatment), rather than the more enduring trait characteristics exhibited prior to the onset of PD. Until longitudinal investigation of personality determinants has been conducted, there should be a cautious approach in screening for at-risk individuals using specific personality attributes, to avoid overlooking persons with PD who may be vulnerable to developing behavioural complications.

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“…Young age at PD onset, high novelty-seeking personality traits and psychosocial factors such as substance abuse and depression may predispose patients to de-veloping DDS [2], which is associated with high levodopa and levodopa equivalent doses [3]. Dopaminergic drugs usually related to DDS are short-acting "rescue" medications as dispersible levodopa and intermittent injections of apomorphine [1].…”

Section: Introductionmentioning

confidence: 99%

Dopamine Dysregulation Syndrome in Parkinson’s Disease Patients with Unsatisfactory Switching from Immediate to Extended Release Pramipexole: A Further Clue to Incentive Sensitization Mechanisms?

Solla

Cannas

Corona

et al. 2013

Behavioural Neurology

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A small proportion of patients with Parkinson’s disease (PD), chronically under dopamine replacement therapy, may undergo an addiction-like behavioral disturbance, named dopamine dysregulation syndrome (DDS). This behavioral disorder is characterized by the increase of doses beyond those required for motor control, and its management remains difficult; thus, early recognition and careful monitoring of at-risk individuals are crucial. We report the cases of two PD patients with a previous unsatisfactory switching from an immediate release (IR) to an extended release (ER) pramipexole formulation who developed DDS. PD patients unsatisfactorily switched from an IR to an ER formulation of dopamine agonists should be considered as at-risk individuals for DDS development.

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Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease

Abstract: These factors may help to identify early patients who are more vulnerable to developing a pattern of compulsive dopaminergic drug use and help minimize its consequences.

Cited by 194 publications

References 30 publications

Neuropsychiatry of Parkinson's disease

Neuropsychiatry of Parkinson's disease

Personality Style in Behavioural Disturbances in Parkinson?s Disease

Dopamine Dysregulation Syndrome in Parkinson’s Disease Patients with Unsatisfactory Switching from Immediate to Extended Release Pramipexole: A Further Clue to Incentive Sensitization Mechanisms?

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