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Reducing Dosage of Parkinson's Drugs may Cause Withdrawal Symptoms
For the first time, researchers have defined this phenomenon, which they call dopamine agonist withdrawal syndrome, or DAWS. Led by a physician-scientist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, the study is reported in the Jan. 11 Archives of Neurology.
"Like cocaine and methamphetamines, dopamine agonists work by stimulating the reward pathways in the brain. For this reason, it makes sense that they would engender similar withdrawal symptoms, particularly in those with high cumulative drug exposure," says senior author Dr. Melissa J. Nirenberg, associate director of the Parkinson's Disease and Movement Disorders Institute at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of neurology and neuroscience at Weill Cornell Medical College.
Dopamine agonists are highly effective drugs that are prescribed to many Parkinson's patients to avoid side effects of the "gold standard" drug L-DOPA, particularly abnormal involuntary movements referred to as dyskinesias. (L-DOPA was perfected by Dr. George C. Cotzias of Cornell University Medical College in the late 1960s; dopamine agonists have been available since the 1990s.) DAs are also FDA-approved for treatment of restless legs syndrome, and used off-label for other conditions such as depression and fibromyalgia. In the United States, there are currently two DAs on the market -- pramipexole (Mirapex®) and ropinirole (Requip®, Requip XL®).
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