Compulsive use of dopamine replacement therapy in Parkinson's disease: reward systems gone awry?

Lancet Neurol. 2003 Oct;2(10):595-604. doi: 10.1016/s1474-4422(03)00529-5.


Dopamine replacement therapy (DRT) is the most effective treatment for Parkinson's disease (PD); it provides substantial benefit for most patients, extends independence, and increases survival. A few patients with PD, however, take increasing quantities of medication far beyond those required to treat their motor disabilities. These patients demand rapid drug escalation and continue to request more DRT despite the emergence of increasingly severe drug-induced motor complications and harmful behavioural consequences. In this article we detail the features of compulsive DRT-seeking and intake in PD, in relation to theories of compulsive drug use.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Disease Management
  • Dopamine / adverse effects
  • Dopamine / therapeutic use*
  • Humans
  • Models, Biological
  • Movement Disorders / etiology
  • Movement Disorders / therapy*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*
  • Reward
  • Substance-Related Disorders


  • Dopamine