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Risk prediction and treatment monitoring are crucial for prevention and management of compulsive dopamine use in Parkinson's disease
  1. Odile A van den Heuvel
  1. Correspondence to Dr O A van den Heuvel, Department of Psychiatry, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands; oa.vandenheuvel{at}vumc.nl

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Parkinson's disease (PD) patients with severe response fluctuations need protection from caregivers, preventing complications from the psychostimulant features of dopamine replacement therapy (DRT)

Despite its positive effects in the treatment for motor symptoms in PD, DRT leads to a number of motor and non-motor side effects. Non-motor side effects include dopamine dysregulation syndrome (DDS) occurring in 3% to 4% of PD patients taking DRT. DDS is characterised by compulsive DRT seeking and hoarding, self-medication and withdrawal symptoms.1 DDS has devastating consequences for daily functioning and is challenging to manage.

Important insights into this condition are offered in the paper by Cilia and colleagues,2 reporting on a retrospective naturalistic longitudinal study on the demographic and clinical risk factors for DDS and the factors related to positive treatment …

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