Florida Fellow Dr. Limotai Publishes Important Study on Addiction-Like Manifestations in Parkinson’s Disease

Natlada Limotai, a fellow at the University of Florida Center for Movement Disorders & Neurorestoration, published an important paper on addiction-like manifestations in Parkinson’s disease.  The data is drawn from a 9 year experience and reveals important information for patients and clinicians using Parkinson’s disease medications. Dr. Limotai has recently moved back to Thailand to help develop a new movement disorders program for her home country.
Int J Neurosci. 2011 Oct 24. [Epub ahead of print]

Addiction-like Manifestations and Parkinson’s Disease: A Large Single Center Nine Year Experience.

Limotai N, Oyama G, Go C, Bernal O, Ong T, Moum SJ, Bhidayasiri R, Foote KD, Bowers D, Ward H, Okun MS.


Department of Neurology, Center for Movement Disorders & Neurorestoration, Gainesville, Florida, U.S.A.


Abstract Objective: Characterize potential risk factors and the relationship of dopamine agonist withdrawal symptoms (DAWS), dopamine dysregulation syndrome(DDS) and impulse control disorders(ICDs) in Parkinson’s disease(PD). Methods: A retrospective chart review categorized cases into three groups; DAWS, DDS and ICDs. Results: A total of 1,040 subjects met inclusion criteria. There were 332 subjects with a history of tapering dopamine agonists(DA), and 26 (7.8%) developed DAWS. Fourteen (1.3%) and 89 (8.6%) met the criteria for both DDS and ICD. Subjects with DAWS, DDS, and ICDs had a higher baseline dose of DA, levodopa(LD), and total dopaminergic medication(p<.05), compared to those without the three conditions. DDS was found to be related to the DAWS group(p<.001). When comparing to the PD population without DDS, young-age at onset of PD (p = 0.027), presence of DAWS (p<.001), ICDs (p = .003) and punding (p = .042) were all correlated with the DDS group; while male sex (p = .045), young-age at onset of PD (p<.001), presence of DAWS (p<.001), and presence of DDS (p = .001) and punding (p<.001) were related to the ICD group. Conclusions: There was a strong relationship between DAWS, DDS and ICD in this large PD cohort. Dopaminergic therapy in a subset of PD patients was strongly associated with addiction-like behavioral issues.

About the Author


Michael Okun

Professor of Neurology, expert on Parkinson's disease and other basal ganglia disorders, deep brain stimulation, author of over 300 research papers and the bestselling book…

Read all articles by Michael Okun