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Behavioural Neurology
Volume 27, Issue 4, Pages 563-566
Clinical Note

Dopamine Dysregulation Syndrome in Parkinson’s Disease Patients with Unsatisfactory Switching from Immediate to Extended Release Pramipexole: A Further Clue to Incentive Sensitization Mechanisms?

Paolo Solla,1 Antonino Cannas,1 Marta Corona,1 Maria Giovanna Marrosu,2 and Francesco Marrosu1

1aMovement Disorders Center, Institute of Neurology, University of Cagliari, Cagliari, Italy
2MS Center, Institute of Neurology, University of Cagliari, Cagliari, Italy

Received 10 December 2012; Accepted 10 December 2012

Copyright © 2013 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A small proportion of patients with Parkinson’s disease (PD), chronically under dopamine replacement therapy, may undergo an addiction-like behavioral disturbance, named dopamine dysregulation syndrome (DDS). This behavioral disorder is characterized by the increase of doses beyond those required for motor control, and its management remains difficult; thus, early recognition and careful monitoring of at-risk individuals are crucial. We report the cases of two PD patients with a previous unsatisfactory switching from an immediate release (IR) to an extended release (ER) pramipexole formulation who developed DDS. PD patients unsatisfactorily switched from an IR to an ER formulation of dopamine agonists should be considered as at-risk individuals for DDS development.