Warren N, et al. - The physicians performed a systematic review of published cases to explain current understanding of presentation, risk factors, comorbidities and management of dopamine dysregulation syndrome (DDS). Early identification of DDS had to be a priority, because of the functional impairment, medical and psychiatric consequences and the difficulties of treatment.

• The physicians identified case reports through a systematic search of databases (PubMed, Embase) with the following terms: dopaminergic dysregulation syndrome, hedonistic homeostatic dysregulation, dopamine/levodopa addiction.

• A total of 390 articles were reviewed, identifying 98 cases of DDS.
• Early-onset Parkinson’s disease (67%) and male gender (83%) were commonly found in the case reports.
• To enable or prevent detection of overuse, as well as mood, anxiety and motor fluctuations, DDS presented with significant physical and social impairment, actions.
• DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) substance use disorder criteria was met by all DDS cases.
• The physicians found past substance and psychiatric history in 15.3% and 10.2% of cases.
• Comorbid impulse control disorders (61%), psychosis (32%) and panic attacks (14%) were commonly seen.
• They used a large variety of management strategies; only 56% of cases resolving.
• In 5/5 cases, sodium valproate was successful.
• In this study, the response to deep brain stimulation varied.