Dopamine agonists and therapy compliance.

Dopamine replacement therapy in Parkinson's disease improves motor symptoms, however some patients suffer from motor and behavioural disturbances attributable to taking doses of medication well beyond the dose required to treat their motor disabilities. Dopamine dysregulation syndrome (DDS) can be regarded as a pattern of compulsive medication use, leading to disabling motor and behavioural features. DDS, probably attributed to pulsatile overstimulation of the limbic dopaminergic system, is characterised by severe dopamine addiction and behavioural disorders such as pathological gambling (PG), hypersexuality, punding and mood swings. PG is a form of impulse control disorder (ICD), consisting of persistent and maladaptive gambling of various types, which affects personal, family and occupational activity. The treatment of the syndrome is difficult, hence a strict adherence to antiparkinson medication should be encouraged for prevention.