Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease.
BACKGROUND
In the course of treatment, a small group of patients with Parkinson disease (PD) develop a harmful pattern of compulsive dopaminergic drug use, called the dopamine dysregulation syndrome (DDS). Individual factors may influence susceptibility.


OBJECTIVE
To identify predisposing factors to DDS in a population of outpatients with PD.


METHODS
The authors compared clinical features, impulsive sensation seeking (ISS) personality traits, past experimental drug use, alcohol consumption, smoking behaviors, and depressive symptoms in 25 patients with DDS to an outpatient sample of 100 patients with PD who were not compulsively overusing dopaminergic medication.


RESULTS
Patients with DDS had a significantly younger age at disease onset, higher dopaminergic drug intake, greater past experimental drug use, more depressive symptoms, scored higher on ISS ratings, and tended to have higher alcohol intake. Using logistic regression analysis, we found that novelty seeking personality traits, depressive symptoms, alcohol intake, and age at PD onset were significant predictors of DDS.


CONCLUSIONS
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.
Evans
A H
AH
Reta Lila Weston Institute of Neurological Studies, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Lawrence
A D
AD
Potts
J
J
Appel
S
S
Lees
A J
AJ
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D015259:Dopamine Agents / Q000009:adverse effects*; D005106:Exploratory Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D012651:Self Medication / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
D015259:Dopamine Agents