Case Reports
doi: 10.1136/jnnp.68.4.423.Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies
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- PMID:10727476
- PMCID: PMC1736875
- DOI: 10.1136/jnnp.68.4.423
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Case Reports
Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies
G Giovannoni et al. J Neurol Neurosurg Psychiatry.2000 Apr.
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Abstract
Hedonistic homeostatic dysregulation is a neuropsychological behavioural disorder associated with substance misuse and addiction. The disorder has been recognised as a consequence of dopamine replacement therapy (DRT) in 15 patients with Parkinson's disease. The syndrome typically develops in male patients with early onset Parkinson's disease, and can occur with orally and subcutaneously administered DRT. These patients take increasing quantities of their DRT, despite increasingly severe drug induced dyskinesias, and may develop a cyclical mood disorder with hypomania or manic psychosis. There is impairment of social and occupational functioning. Tolerance develops to mood elevating effects of DRT and a negative affective withdrawal state occurs if the drugs are withdrawn or doses decreased. The clinical features and guidelines for managing this syndrome are discussed. A set of diagnostic criteria for further investigating this condition is proposed.
Comment in
- A window on the role of dopamine in addiction disorders.Cummings JL.Cummings JL.J Neurol Neurosurg Psychiatry. 2000 Apr;68(4):404. doi: 10.1136/jnnp.68.4.404.J Neurol Neurosurg Psychiatry. 2000.PMID:10727473Free PMC article.No abstract available.
- Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies.Cantello R.Cantello R.J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):566-7. doi: 10.1136/jnnp.69.4.566a.J Neurol Neurosurg Psychiatry. 2000.PMID:11183044Free PMC article.No abstract available.
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