Psychostimulant effect of dopaminergic treatment and addictions in Parkinson's disease.
Mov Disord
; 32(11): 1566-1573, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28737225
ABSTRACT
BACKGROUND:
Dopamine replacement therapy in PD has been associated with both behavioral addictions and dopamine addiction.OBJECTIVES:
To investigate potential association between l-dopa induced neuropsychiatric fluctuations and addictions in PD.METHODS:
A cohort of 102 patients with PD suffering from motor complications of l-dopa treatment was prospectively analyzed. We evaluated dopamine addiction, behavioral addictions, and neuropsychiatric fluctuations using the Ardouin scale of behavior in PD.RESULTS:
Patients with (n = 51) or without (n = 51) neuropsychiatric fluctuations did not differ in age, disease duration, medication, or UPDRS III motor score during on and off drug condition. Patients with neuropsychiatric fluctuations had a higher H & Y stage in off-drug condition. A multivariate model showed that dopamine addiction (odds ratio 8.9; P = 0.02) and behavioral addictions (odds ratio 3.76; P = 0.033) were more frequent in the presence of neuropsychiatric fluctuations. Behavioral addictions and dopamine addiction were more frequent in the presence than in the absence of on-drug euphoria (46% vs. 13.9%; P < 0.001 and 27% vs 6.2 %; P = 0.003), while conversely, no association emerged between dopamine or behavioral addictions and presence of off-drug dysphoria. Patients with neuropsychiatric fluctuations had a poorer quality of life and a more frequent history of anxiety disorder.CONCLUSIONS:
The psychostimulant effects of dopamine treatment during on-drug euphoria, rather than avoidance of off-drug dysphoria, appear to drive both behavioral addictions and abuse of medication. © 2017 International Parkinson and Movement Disorder Society.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
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Dopaminérgicos
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Levodopa
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Comportamento Aditivo
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Transtornos Relacionados ao Uso de Substâncias
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Transtorno Depressivo
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Euforia
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Estimulantes do Sistema Nervoso Central
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article