• Natlada Limotai, Genko Oyama, Criscely Go, Oscar Bernal, Tiara Ong, Sarah J Moum, Roongroj Bhidayasiri, Kelly D Foote, Dawn Bowers, Herbert Ward, and Michael S Okun.
• Department of Neurology, Center for Movement Disorders & Neurorestoration, Gainesville, Florida 32611, USA.
• Int. J. Neurosci. 2012 Mar 1; 122 (3): 145-53.

ObjectiveCharacterize potential risk factors and the relationship of dopamine agonist (DA) withdrawal syndrome (DAWS), dopamine dysregulation syndrome (DDS), and impulse control disorders (ICDs) in Parkinson's disease (PD).MethodsA retrospective chart review categorized cases into three groups: DAWS, DDS, and ICDs.ResultsA total of 1,040 subjects met inclusion criteria. There were 332 subjects with a history of tapering DAs and 26 (7.8%) developed DAWS. Fourteen (1.3%) and 89 (8.6%) met the criteria for both DDS and ICD. Subjects with DAWS, DDS, and ICDs had a higher baseline dose of DA, levodopa, and total dopaminergic medication (p < .05), compared to those without the three conditions. DDS was found to be related to the DAWS group (p < .001). When comparing to the PD population without DDS, younger age at onset of PD (p = .027), presence of DAWS (p < .001), ICDs (p = .003), and punding (p = .042) were all correlated with the DDS group, while male sex (p = .045), younger age at onset of PD (p < .001), presence of DAWS (p < .001), and presence of DDS (p = .001) and punding (p < .001) were related to the ICD group.ConclusionsThere was a strong relationship between DAWS, DDS, and ICD in this large PD cohort. Dopaminergic therapy in a subset of PD patients was strongly associated with addiction-like behavioral issues.

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