Highlights
- •DAWS affects up to 19% of PD patients who undergo a dopamine agonist taper.
- •ICD is a significant risk factor, not a requirement for development of DAWS.
- •Recent data suggest that history of DBS may also be a risk factor for DAWS.
- •Close surveillance for DAWS is crucial during dopamine agonist taper.
Abstract
Dopamine agonists are effective and widely used treatments for Parkinson disease (PD).
However, patients on dopamine agonists may experience significant side effects which
necessitate dose tapering or discontinuation. Dopamine agonist withdrawal syndrome
(DAWS) is a complication that affects up to 19% of PD patients who undergo a dopamine
agonist taper. It was initially described in 2010 as a severe stereotypical cluster
of psychiatric and physical symptoms occurring with dopamine agonist withdrawal. Identified
risk factors for DAWS include impulse control behavior disorders (ICD) and higher
dopamine agonist dosage. There are emerging data suggesting that the dopamine agonist
withdrawal in the setting of history of deep brain stimulation may also be a risk
factor. Currently there is no standard treatment for DAWS. Therefore early recognition
of risk factors is crucial for prevention. It's important to closely monitor for withdrawal
symptoms in high-risk patients undergoing a dopamine agonist taper.
Keywords
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References
- Dopamine agonist withdrawal syndrome in Parkinson disease.Arch. Neurol. 2010; 67: 58-63
- Dopamine agonist withdrawal syndrome (DAWS) in a tertiary Parkinson's disease center [abstract].Mov. Disord. 2016; 31
- Clinical features of dopamine agonist withdrawal syndrome in a movement disorders clinic.J. Neurol. Neurosurg. Psychiatry. 2013; 84: 130-135
- Dopamine agonist withdrawal syndrome in a patient with restless leg syndrome.Parkinsonism Relat. Disord. 2013; 19: 269-270
- Neural reward processing under dopamine agonists: imaging.J. Neurol. Sci. 2011; 310: 36-39
- Higher doses of dopamine agonists, impulse control disorders and history of deep brain stimulation (DBS): risk factors for dopamine agonists withdrawal syndrome (DAWS)? [abstract].Mov. Disord. 2016; 31
- Identification of possible risk factors for the development of dopamine agonist withdrawal syndrome in Parkinson's disease.Parkinsonism Relat. Disord. 2012; 18: 1051-1052
Article info
Publication history
Published online: January 03, 2017
Accepted:
December 30,
2016
Received in revised form:
December 27,
2016
Received:
December 21,
2016
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
