Too much of a good thing

[Farooqji]

The publication twenty years ago describing excessive therapeutic drug dosing in some Parkinson's disease patients foreshadowed behaviours now well recognised.

The recognition and description of a behavioural syndrome in a group of patients with Parkinson’s disease (PD) who take dopamine replacement therapy in quantities beyond what is required to treat motor symptoms 20 years ago1 sparked interest for a number of reasons. In addition to its deficiency being integral to PD, dopamine had long been regarded as a critical neurotransmitter involved in reward systems reduction in dopamine associated with depression and increased dopamine with addiction. Within the addiction field, these patients represented a real-life experiment to support the prevailing models suggesting maladaptive mesolimbic dopamine circuits underlying addiction.

jnnp.bmj.com/content/91/6/5...

[sharoncrayn]

An important comment from this paper:

"found levodopa intestinal gel infusion (LCIG) and subthalamic nucleus deep brain stimulation (DBS) beneficial in a large proportion of their patients.8 These device-assisted therapies were not widely available at the time of our report. Patients with dopamine dysregulation undergoing any device assisted therapies still require extensive multidisciplinary intervention and symptoms may persist or even originate after DBS and LCIG."

Sharon