Article thumbnail

Dopamine-Induced Nonmotor Symptoms of Parkinson's Disease

By Ariane Park and Mark Stacy


Nonmotor symptoms of Parkinson's disease (PD) may emerge secondary to the underlying pathogenesis of the disease, while others are recognized side effects of treatment. Inevitably, there is an overlap as the disease advances and patients require higher dosages and more complex medical regimens. The non-motor symptoms that emerge secondary to dopaminergic therapy encompass several domains, including neuropsychiatric, autonomic, and sleep. These are detailed in the paper. Neuropsychiatric complications include hallucinations and psychosis. In addition, compulsive behaviors, such as pathological gambling, hypersexuality, shopping, binge eating, and punding, have been shown to have a clear association with dopaminergic medications. Dopamine dysregulation syndrome (DDS) is a compulsive behavior that is typically viewed through the lens of addiction, with patients needing escalating dosages of dopamine replacement therapy. Treatment side effects on the autonomic system include nausea, orthostatic hypotension, and constipation. Sleep disturbances include fragmented sleep, nighttime sleep problems, daytime sleepiness, and sleep attacks. Recognizing the non-motor symptoms that can arise specifically from dopamine therapy is useful to help optimize treatment regimens for this complex disease

Topics: Review Article
Publisher: SAGE-Hindawi Access to Research
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (1997). A .A lb ane se ,G .M aria,A .Be nt i v oglio ,G .Brisind a,E .C asse t t
  2. (2007). A .C annas,P .Solla,G .L.F loris,G .Se rra,P .T ac c oni,andM.G . Marrosu, “Aberrant sexual behaviours in Parkinson’s disease during dopaminergic treatment,”
  3. (2005). A .H .E v a n s ,A .D .L a w r e n c e ,J .P o t t s ,S .A p p e l ,a n dA
  4. (2009). A reassessment of risks and benefits of dopamine agonists
  5. (1973). Amphetamines. Valuable adjunct in treatment ofParkinsonism,”New York State
  6. (2006). and J.P.Larsen,“Excessive daytimesleepinessinParkinsondisease: is it the drugs or the disease?” Neurology,v o l .6 7 ,n o .5 ,p p .
  7. (2010). Arnulf et al., “Practice Parameter: treatment of nonmotor symptoms of Parkinson disease:
  8. (2000). Association, Task Force on DSM-IV.
  9. (2007). B i g l a n ,R .G .H o l l o w a yJ r .
  10. (2006). Compulsive drug use linked to sensitized ventral striatal dopamine transmission,”
  11. (2007). Continuous dopaminergic stimulation: is it the answer to the motor complications of levodopa?”
  12. (2005). D o w l i n g ,J .M a s t i c k ,E .C o l l i n g ,J .H .C a r t e r
  13. De Zwaan et al., “Compulsive buying: descriptive characteristics and psychiatric comorbidity,”
  14. (2005). Dietary herb extract dai-kenchu-to ameliorates constipation in parkinsonian patients (Parkinson’s disease and multiple system atrophy),”
  15. (2004). Dopamine agonists and sleepiness in PD: review of the literature and personal findings,”
  16. (2009). Dopamine dysregulation syndrome in a patient with restless legs syndrome,”
  17. (2009). Dopamine dysregulation syndrome, impulse control disorders and punding after deep brain stimulation surgery for Parkinson’s disease,”
  18. (2005). Double-blind, placebo-controlled, unforced titrationparallel trialofquetiapinefordopaminergic-inducedhallucinationsin
  19. (2006). e i n t r a u b ,A .D .S i d e r o w f ,M .N .P o t e n z ae ta l . ,“ A s s o c i a -tion of dopamine agonist use with impulse control disorders
  20. (2000). e n e l o n ,F .M a h i e u x ,R .H u o n ,a n dM .Z i´ egler,
  21. (2008). e r b a a n ,S .M .V a nR o o d e n ,M .V i s s e r ,J .M a r i n u s ,a n dJ .J . VanHilten, “Nighttime sleep problemsanddaytime sleepiness
  22. (2010). eintraub ,J.K oester ,M.N.P otenzaetal.,“Impulsecontrol disorders in Parkinson disease: a cross-sectional study of 3090 patients,”
  23. (1999). Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole,”
  24. (2009). H.Honig,A.Antonini,P.Martinez-Martin etal.,“Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life,”
  25. (2000). Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies,”
  26. (2006). i n g e r ,P .S a n d r o n i ,T .L .O p f e r - G e h r k i n ge ta l . ,“ P y r i -dostigminetreatment trial in neurogenic orthostatichypotension,”
  27. (2004). Improvementofsleep quality in patients with advanced Parkinson’s disease treated with deep brain stimulation of the subthalamic nucleus,”
  28. (2009). Impulse control disorders in Parkinson’s disease: prevalence and possible risk factors,”
  29. (2009). Impulse controldisordersinParkinson’sdisease:definition,epidemiology, risk factors, neurobiology and management,”
  30. (2009). Impulsive and compulsive behaviors in Parkinson’s disease,”
  31. (2007). Lubiprostone, a locally acting chloride channel activator, in adult patients with chronic constipation: a double-blind, placebo-controlled, dose-ranging study to evaluate efficacy and safety,” Alimentary Pharmacology and Therapeutics,
  32. (2007). Macrogol for the treatment of constipation in Parkinson’s disease.
  33. (1999). Managing late complications of Parkinson’s disease,”
  34. (2001). Moal,“Drug addiction, dysregulation of reward,
  35. (2005). Mosapride citrate, a novel 5-HT4 agonist and partial 5-HT3 antagonist, amerliorates constipation in Parkinsonian patients,”
  36. (1997). o s ta n dK .S c h i m r i g k ,“ L o n g - t e r mr e s u l t sw i t h cisapride in Parkinson’s disease,”
  37. (2007). oon,T .T homse n,J .M.M i y asakie tal. ,“ F ac t or sassoc iat e d with dopaminergic drug-related pathological gambling
  38. (2006). Orthostatic hypotension as an early finding
  39. (2010). Pathological gambling in parkinson disease is reduced by amantadine,”
  40. (2006). Pathological gambling in Parkinson’s disease improves on chronic subthalamic nucleus stimulation,”
  41. (2007). Pathological gambling in Parkinson’s disease: risk factors and differences from dopamine dysregulation. An analysisof published case series,”
  42. (2003). Pathological gamblingassociatedwithdopamineagonisttherapyinParkinson’s disease,”
  43. (2006). Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the quality standards subcommittee of the
  44. (2005). Prevalence and clinical features of hedonistic homeostatic dysregulation
  45. (2006). Prospective prevalence of pathologic gambling and medication association in Parkinson disease,”
  46. (2006). Punding and dyskinesias,” Movement Disorders,v o l
  47. (2004). Punding in Parkinson’s disease: its relation to the dopaminedysregulation syndrome,”
  48. (2007). Punding prevalence in Parkinson’s disease,”
  49. (1983). Pyridostigmine bromide and constipation in Parkinson’s disease,”
  50. (2002). r u n n e r ,T .C .W e t t e r ,B .H o e g l ,A .Y a s s o u r i d i s
  51. (2010). R˚ uˇ ziˇ cka et al., “Effects of ropinirole prolonged-release on sleep disturbances and daytime sleepiness
  52. (2009). R.A.PintoandD.R.Sands,“Surgery andsacralnervestimulation for constipation and fecal incontinence,”
  53. (2003). Randomizedtrialofmodafinilfortreatingsubjective daytime sleepiness in patients with Parkinson’s disease,”
  54. (2004). Rascol et al., “Clozapine in drug induced psychosis in Parkinson’s disease: a randomised, placebo controlled study with open follow up,”
  55. (2008). S t o w e ,N .J .I v e s ,C .C l a r k ee ta l . ,“ D o p a m i n ea g o n i s t therapy
  56. (2003). Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson’s disease,”
  57. (2002). Sleep disorders in Parkinson’s disease: epidemiology and management,”
  58. (2003). Sleep disturbances in Parkinson’s disease,” Current Neurology and Neuroscience Reports,v o l .3 ,n o .2 ,p p .
  59. (2008). Sodium oxybate for excessive daytime sleepiness in Parkinson disease: an openlabel polysomnographic study,”
  60. (2006). Staffe t t i ,R .A .H a u s e r ,P .B .D u n n e ,a n d
  61. (2005). Symptoms of autonomic failure in Parkinson’s disease: prevalence and impact on daily life,”
  62. (2009). Treatment of dysautonomia associated with Parkinson’s disease,”
  63. (2006). u ,A .B h a r m a l ,a n dO .S u c h o w e r s k y ,“ G a m b l i n ga n d Parkinsondisease,”Archives of Neurology,
  64. (2007). Using STN DBS and medication reduction as a strategy to treat pathological gambling
  65. (1996). Visual hallucinations associated with Parkinson disease,”
  66. (2003). wr enc e,A.H.E vans,andA.J .Lees,“ C ompulsi v euseof dopamine replacement therapy in Parkinson’s disease: reward systems gone awry?”