Compulsive use of dopaminergic drug therapy in Parkinson's disease: Reward and anti‐reward
Abstract
A few Parkinson patients develop a disabling pattern of compulsive dopaminergic drug use (“dopamine dysregulation syndrome”—DDS). DDS patients commonly identify aversive dysphoric “OFF” mood‐states as a primary motivation to compulsively use their drugs. We compared motoric, affective, non‐motor symptoms and incentive arousal after overnight medication withdrawal and after levodopa in DDS and control PD patients. Twenty DDS patients were matched to 20 control PD patients for age, gender, and disease duration and underwent a standard levodopa challenge. Somatic symptomatology, positive and negative affective states, drug effects, reward responsivity, motor disability, and dyskinesias were tested in the “OFF”‐state after overnight withdrawal of medications, and then after a challenge with a standard dose of levodopa, after a full “ON”‐state was achieved. In the “OFF”‐state, DDS patients reported lower positive affect, and more motor and non‐motor disability. In the “ON”‐state, DDS patients had higher expressions of drug “wanting,” reward responsivity, and dyskinesias. Positive and negative affect, non‐motor symptomatology, and motor disability were comparable. These findings suggest that affective, motivational, and motoric disturbances in PD are associated with the transition to compulsive drug use in individuals who inappropriately overuse their dopaminergic medication. © 2010 Movement Disorder Society
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DDS occurs in a small proportion of Parkinson's patients being treated with dopamine agonist medication.
“DDS occurs in a small proportion of Parkinson’s patients being treated with dopamine agonist medication (Dodd et al., 2005; Evans, Lawrence, Cresswell, Katzenschlager, & Lees, 2010; Evans et al., 2006).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Evans, Lawrence, Cresswell, Katzenschlager, & Lees, 2010
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Limbrick‐Oldfield, E. H. (2012) · Spiral (Imperial College London) · doi:10.25560/14511
- Authors
- Evans, A. H., Lawrence, A. D., Cresswell, S. A., Katzenschlager, R., & Lees, A. J.
- Affiliations
- The Royal Melbourne Hospital (AU)
- Cardiff University (GB)
- Donauspital (AT)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Lees, Andrew J.
- Venue
- Movement Disorders
- Publisher
- Wiley
- Published
- 2010-05-05
- Volume
- 25
- Issue
- 7
- Pages
- 867-876
- ISSN
- 0885-3185 (ISSN-L)
- 1531-8257
- OpenAlex
- W2098354188
- Cited by
- 51
- References
- 43
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 5 · 2013: 6 · 2012: 9
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Movement Disorders (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- dopamine dysregulation syndrome, Parkinson's disease, compulsive drug use, levodopa challenge, OFF state, drug withdrawal, reward sensitivity, dyskinesia, positive and negative affect, non-motor symptoms, motor impairment
- MeSH terms
- Affect, Compulsive Behavior, Drug Administration Schedule, Female, Humans, Levodopa, Male, Middle Aged, Parkinson Disease, Surveys and Questionnaires, Severity of Illness Index, Substance Withdrawal Syndrome, Treatment Outcome, Dopamine Agonists
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