Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies
Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies
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DOI：
10.1136/jnnp.68.4.423
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发表时间：
2000-04-01
影响因子：
11
通讯作者：
Lees, AJL
中科院分区：
文献类型：
--
作者：
Giovannoni, G;O'Sullivan, JD;Lees, AJL
享乐主义稳态失调是一种与物质滥用和成瘾相关的神经心理行为障碍。这种疾病已被确认为多巴胺替代疗法（DRT）在15例帕金森病患者的结果。该综合征通常发生在患有早发性帕金森病的男性患者中，并且可以在口服和皮下施用DRT时发生。这些患者服用越来越多的DRT，尽管越来越严重的药物诱导的运动障碍，并可能发展为轻躁狂或躁狂精神病的周期性情绪障碍。社会和职业功能受损。对DRT的情绪提升作用产生耐受性，如果药物被撤回或剂量减少，则会出现负面情感撤回状态。临床特点和管理这种综合征的指导方针进行了讨论。提出了一套诊断标准，进一步调查这种情况。
Hedonistic homeostatic dysregulation is a neuropsychological behavioural disorder associated with substance misuse and addiction. The disorder has been recognised as a consequence of dopamine replacement therapy (DRT) in 15 patients with Parkinson's disease. The syndrome typically develops in male patients with early onset Parkinson's disease, and can occur with orally and subcutaneously administered DRT. These patients take increasing quantities of their DRT, despite increasingly severe drug induced dyskinesias, and may develop a cyclical mood disorder with hypomania or manic psychosis. There is impairment of social and occupational functioning. Tolerance develops to mood elevating effects of DRT and a negative affective withdrawal state occurs if the drugs are withdrawn or doses decreased. The clinical features and guidelines for managing this syndrome are discussed. A set of diagnostic criteria for further investigating this condition is proposed.