Dopamine agonist withdrawal syndrome (DAWS) in a tertiary Parkinson disease treatment center
| Autor: | Kaley O'Donnell, Mohammad Edrees Mohammad, Kathryn Sutton, Katelyn Vlastaris, Xiomara Garcia, Xin Xin Yu, Shnehal Patel, Hubert H. Fernandez |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Side effect Population Dopamine agonist Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Dopamine Risk Factors Prevalence Medicine Humans education Disease treatment Aged Ohio Retrospective Studies education.field_of_study business.industry Parkinson Disease Middle Aged Discontinuation Substance Withdrawal Syndrome 030104 developmental biology Neurology Anesthesia Cohort Dopamine Agonists Female Neurology (clinical) Withdrawal syndrome business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of the neurological sciences. 379 |
| ISSN: | 1878-5883 |
| Popis: | Introduction Dopamine agonists are a mainstay of treatment for patients with Parkinson disease (PD). However, side effects limit their use, often necessitating dose change. Upon withdrawal, patients may experience dopamine agonist withdrawal syndrome (DAWS). To date, there is no established protocol for the prevention or treatment of DAWS. Methods We performed a retrospective chart review of PD patients who were taking a dopamine agonist. Results In our large cohort of 313 PD patients who were on a dopamine agonist, we found that 39.5% (n = 124) had a change in their dose of medication for various reasons, including 102 patients who experienced a side effect on a dopamine agonist. Twenty out of 102 patients (19.6%) developed symptoms consistent with DAWS, whereas 1 out of 22 patients (4.5%) who had medication dose changed due to any other reason (e.g. dyskinesias, DBS surgery, decreased by another provider, etc.) developed symptoms consistent with DAWS. Our DAWS population had a shorter duration of PD, less exposure to a dopamine agonist, and was on a lower dose compared to those patients who did not develop DAWS. Agitation was the most common DAWS symptom reported in our cohort. Interestingly, in terms of developing DAWS, the prevalence of DAWS (19.0% vs 16.5%; p = 0.76) between partial versus total discontinuation was not significantly different whether the dopamine agonist dose was decreased (21 patients) or completely stopped (103 patients). Conclusion Contrary to previous reports, we have found that other side effects besides impulse control behavioral disorders also increase risk for developing DAWS. Furthermore, the prevalence of DAWS did not differ between partial versus total discontinuation of the dopamine agonist. |
| Databáze: | OpenAIRE |
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