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Letters   |    
Successful Treatment of Dopamine Dysregulation Syndrome With Valproic Acid
Jane Epstein, M.D.; Carolina Jimenez Madiedo, M.D.; Leonard Lai, M.D.; Michael T. Hayes, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E3. doi:10.1176/appi.neuropsych.13060126
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The authors report no financial relationships with commercial interests.

Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA

Department of Psychiatry, Brigham and Women’s Faulkner Hospital, Boston, MA

Department of Neurology, Brigham and Women’s Hospital, Boston, MA

Send correspondence to Dr. Epstein; e-mail: jiepstein@partners.org

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: Dopamine dysregulation syndrome (DDS) is a maladaptive behavioral pattern of excessive and compulsive seeking of dopamine replacement therapy (DRT) beyond what is necessary to control motor symptoms of Parkinson’s Disease (PD).1 In addition to behaviors related to drug seeking, it can involve aggressive, hypomanic, impulsive, and compulsive behaviors associated with excessive use of DRT; and dysphoria and anxiety associated with withdrawal states. Although various management strategies have been explored, no clearly effective treatment has been established.2,3 Recently, Sriram et al4 published a consecutive case series of four patients successfully treated for DDS with valproic acid. We present an additional case of successful treatment using this approach.

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References

Giovannoni  G;  O’Sullivan  JD;  Turner  K  et al:  Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies.  J Neurol Neurosurg Psychiatry 2000; 68:423–428
[CrossRef] | [PubMed]
 
Katzenschlager  R:  Dopaminergic dysregulation syndrome in Parkinson’s disease.  J Neurol Sci 2011; 310:271–275
[CrossRef] | [PubMed]
 
Cilia  R;  Siri  C;  Canesi  M  et al:  Dopamine dysregulation syndrome in Parkinson’s disease: from clinical and neuropsychological characterisation to management and long-term outcome.  J Neurol Neurosurg Psychiatry 2014; 85:311–318
[CrossRef] | [PubMed]
 
Sriram  A;  Ward  HE;  Hassan  A  et al:  Valproate as a treatment for dopamine dysregulation syndrome (DDS) in Parkinson’s disease.  J Neurol 2013; 260:521–527
[CrossRef] | [PubMed]
 
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