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Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease

From Reta Lila Weston Institute of Neurological Studies and The National Hospital for Neurology and Neurosurgery (A.H. Evans and Drs. Appel and Lees), Queen Square, London; and MRC Cognition and Brain Sciences Unit (Drs. Lawrence and Potts), Cambridge, UK.

Address correspondence and reprint requests to Professor Andrew J. Lees, Reta Lila Weston Institute of Neurological Studies, Windeyer Building, 46 Cleveland Street, London W1T 4JF, UK; e-mail: alees{at}ion.ucl.ac.uk

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.

Objectives: 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.

Disclosure: The authors report no conflicts of interest.

Received May 23, 2005. Accepted in final form August 1, 2005.

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