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Includes Expert Content
Dopamine Dysregulation Syndrome or Dopamine Agonnist Withdrawal Syndrom
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sparky1109 posted:
My searches on the internet have revealed that a small number of patients taking Dopamine Agonists may develop sensitivity to the drugs resulting in severe behavioral probllems similar to bi-polar 1 disease. However the reports are not easily interpreted, and seem to me, to refer to a single study. How much research is actually going on regarding this? Is there an approved diagnosis? What can you tell me about this?
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DUKE MEDICINE
Mark A Stacy, MD responded:
Hi, sparky1109
Dopamine Dysregulation Syndrome is a condition in which PD patients take too much medication, often without their doctor's of family's knowledge. This leads to sleep difficulties, secrecy, mood swings, and may be associated with Impulse Control Disorders.

Impulse Control Disorders include repetitive activities, often interfering with normal daily routines (endless play or work on the computer - hey that one hits close to home! - constant collecting and re-arranging things, working puzzles or sudoku all the time are a few examples). There are also addictive behaviors, such as compulsive gambling and spending, binge eating or sweet craving, and hypersexuality (from pornography addiction to multiple affairs to hiring prostitutes). These are all potentially serious issues and should be discussed with your doctor. The treatment is safe (and doctor supervised) reduction of your anti-parkinson medications.

If you do not gradually reduce your medications, you may develop a Dopamine Withdrawal Syndrome, a condition described by Dr. Melissa Nirenberg at Cornell University. This manuscript, in the Archives of Neurology, is the one I suspect you keep finding.

We have recently reported that Impulse Control Disorders may occur in more that 15% of the PD population [see Weintraub and others, Annals of Neurology>.


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