Addiction-like manifestations and Parkinson's disease: a large single center 9-year experience

Int J Neurosci. 2012 Mar;122(3):145-53. doi: 10.3109/00207454.2011.633722. Epub 2011 Dec 6.


Objective: Characterize 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).

Methods: A retrospective chart review categorized cases into three groups: DAWS, DDS, and ICDs.

Results: A 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.

Conclusions: There 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.

Publication types

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

MeSH terms

  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / blood
  • Cohort Studies
  • Comorbidity
  • Disruptive, Impulse Control, and Conduct Disorders / chemically induced*
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology
  • Disruptive, Impulse Control, and Conduct Disorders / physiopathology*
  • Dopamine Agonists / adverse effects*
  • Dopamine Agonists / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology
  • Parkinson Disease / physiopathology
  • Retrospective Studies
  • Sex Distribution
  • Substance Withdrawal Syndrome / epidemiology
  • Substance Withdrawal Syndrome / physiopathology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / physiopathology*


  • Antiparkinson Agents
  • Dopamine Agonists