Objective: To describe a case of dopamine dysregulation syndrome managed by safinamide.

Background: Dopamine dysregulation syndrome (DDS) is an uncommon non-motor symptom of Parkinson disease (PD). DDS occurred in 3-4% of patients with advanced PD, who characterized by addictive behavior with excessive use of dopaminergic replacement therapy (DRT) to avoid the unfavorable effects of the withdrawal of DRT. Patients express the need to increase DRT dosing despite evidence of peak-dose dyskinesia. There is no standard therapy for DDS because the treatment approach should be tailored to the individual’s specific needs. However, the general principles of treatment for DDS often involve gradually reducing dopaminergic medications.

Method: Case report.

Results: A 64-year-old man had right side bradykinesia 9 years ago and was diagnosed with Parkinson’s disease. He visited me 6 years ago, at that time he had mild motor fluctuation, but was well controlled by L-dopa of 450mg/day. Motor fluctuation symptoms had worsened since 3 years ago, and entacapone and dopamine agonist were added to control them, but both were discontinued due to side effects. At least, the symptoms were controlled by administering sustained-release formulation of L-dopa 4 to 5 times a day. Two years ago, the patient took an excessive dose of L-dopa without permission. He took 150mg of L-dopa in regular form as little as 7 times a day, up to 15 times a day. After adding 50 mg of safinamide, the frequency of taking L-dopa began to decrease to 7 times a day after one month, and decreased to 4 times a day after 4 months. Until now, one year later, the patient keep taking L-dopa 150mg 4 times a day.

Conclusion: DDS is a rare but difficult to manage. We suggest the safinamide can be a way to control DDS through this case.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/dopamine-dysregulation-syndrome-in-parkinsons-disease-controlled-by-safinamine/