Yu Xin Xin, Fernandez Hubert H
Center for Neurological Restoration, Cleveland Clinic, 9500 Euclid Ave U2, Cleveland, OH, USA.
Center for Neurological Restoration, Cleveland Clinic, 9500 Euclid Ave U2, Cleveland, OH, USA.
J Neurol Sci. 2017 Mar 15;374:53-55. doi: 10.1016/j.jns.2016.12.070. Epub 2017 Jan 2.
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.
多巴胺激动剂是治疗帕金森病（PD）的有效且广泛使用的药物。然而，服用多巴胺激动剂的患者可能会出现严重的副作用，这就需要逐渐减少剂量或停药。多巴胺激动剂撤药综合征（DAWS）是一种并发症，在接受多巴胺激动剂减量的PD患者中，高达19%的患者会受到影响。它最初在2010年被描述为多巴胺激动剂撤药时出现的一组严重的刻板性精神和身体症状。已确定的DAWS风险因素包括冲动控制行为障碍（ICD）和较高的多巴胺激动剂剂量。有新的数据表明，在有脑深部刺激病史的情况下停用多巴胺激动剂也可能是一个风险因素。目前，对于DAWS尚无标准治疗方法。因此，早期识别风险因素对于预防至关重要。对于正在接受多巴胺激动剂减量的高危患者，密切监测撤药症状非常重要。
