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Addiction and Parkinson’s Disease

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Drug Abuse and Addiction in Medical Illness

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Abstract

Parkinson’s disease (PD) is a neurodegenerative disease characterized by tremor, rigidity, and akinesia. PD patients are commonly treated by dopamine replacement therapy (DRT). The degeneration of the dopaminergic system and the longstanding exposure to DRT may cause, in a group of vulnerable patients, dysregulation of the brain reward system. These patients develop DRT-related compulsions, which include addiction to levodopa or dopamine dysregulation syndrome (DDS), punding, and impulse control disorders (ICDs). ICDs or behavioral addiction reported in PD include pathological gambling, hypersexuality, compulsive buying, and binge eating. Although the underlying pathophysiology is still poorly understood, these behaviors are linked by their reward-based and repetitive nature. Such behaviors may result in psychosocial impairment for the patients and are often hidden. The recognition of these behaviors is important and allows a better clinical management. Although the limited data do not permit particular therapeutic strategies, some approaches are worth considering: DRT reduction, trials of nondopaminergic medications and subthalamic chronic stimulation.

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Abbreviations

DBS:

Deep brain stimulation

DDS:

Dopamine dysregulation syndrome

DRT:

Dopamine replacement therapy

ICD:

Impulse control disorder

OCD:

Obsessive–compulsive disorder

PD:

Parkinson’s disease

STN:

Subthalamic nucleus

VTA:

Ventral tegmental area

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Authors and Affiliations

  1. Clinical Neurosciences Department, Movement Disorders Unit, CHU Timone, 264 rue Saint Pierre, 13385, Marseille, France

    Tatiana Witjas, Jean Philippe Azulay & Alexandre Eusebio

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  1. Tatiana Witjas
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  2. Jean Philippe Azulay
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  3. Alexandre Eusebio
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Correspondence to Tatiana Witjas .

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Editors and Affiliations

  1. Inst. Pharmaceutical Sciences, Department of Psychopharmacology, Utrecht University, Universiteitsweg 99, Utrecht, 3584CG, Netherlands

    Joris C. Verster

  2. Dept. Psychiatry, Medical University of South Carolina, President St. 67, Charleston, 29425, South Carolina, USA

    Kathleen Brady

  3. School of Medicine, Div. Alcoholism & Drug Abuse, New York University, First Ave. 550, New York, 10016, New York, USA

    Marc Galanter

  4. Institute of Psychiatry, King's College London, National Addiction Centre, Windsor Walk 4, London, SE5 8AF, United Kingdom

    Patricia Conrod

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Witjas, T., Azulay, J.P., Eusebio, A. (2012). Addiction and Parkinson’s Disease. In: Verster, J., Brady, K., Galanter, M., Conrod, P. (eds) Drug Abuse and Addiction in Medical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3375-0_29

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