@article {Giovannoni423, author = {G Giovannoni and J D O{\textquoteright}Sullivan and K Turner and A J Manson and A J L Lees}, title = {Hedonistic homeostatic dysregulation in patients with Parkinson{\textquoteright}s disease on dopamine replacement therapies}, volume = {68}, number = {4}, pages = {423--428}, year = {2000}, doi = {10.1136/jnnp.68.4.423}, publisher = {BMJ Publishing Group Ltd}, 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{\textquoteright}s disease. The syndrome typically develops in male patients with early onset Parkinson{\textquoteright}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 Tolerance develops to mood elevating effects of DRT and a negative affective withdrawal state occurs if the drugs are withdrawn or doses decreased.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.}, issn = {0022-3050}, URL = {https://jnnp.bmj.com/content/68/4/423}, eprint = {https://jnnp.bmj.com/content/68/4/423.full.pdf}, journal = {Journal of Neurology, Neurosurgery \& Psychiatry} }