Dopamine dysregulation syndrome induced by proxy

BMJ Case Rep. 2019 May 16;12(5):e228495. doi: 10.1136/bcr-2018-228495.

Abstract

Dopamine dysregulation syndrome is a rare complication of Parkinson's disease (PD) treatment. We present a 70-year-old woman with a long-standing PD and a clinical picture compatible with dopaminergic dysregulation, which was ultimately revealed to be induced by her companion. Patient's exuberant choreiform dyskinesia led to a potential financial advantage when performed outside the hospital but excessive dopamine intake also occurred during hospital admission, without any obvious reward for the abuser. Even in cases where there is no place for a definitive diagnosis, deceptive behaviours must be identified as their management is based on psychological and social support in parallel to the adjustment of PD therapy.

Keywords: Parkinson’s disease; impulse control disorders.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carbidopa / administration & dosage
  • Carbidopa / adverse effects*
  • Disruptive, Impulse Control, and Conduct Disorders / chemically induced*
  • Disruptive, Impulse Control, and Conduct Disorders / diagnosis
  • Drug Combinations
  • Female
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects*
  • Parkinson Disease / drug therapy*
  • Substance-Related Disorders / complications
  • Syndrome

Substances

  • Drug Combinations
  • carbidopa, levodopa drug combination
  • Levodopa
  • Carbidopa