Rasagiline Withdrawal Syndrome in Parkinson’s Disease
Parkinson’s disease (PD) patients using dopamine agonists can develop withdrawal symptoms, referred to as dopamine agonist withdrawal syndrome (DAWS), under dose tapering or discontinuation of these drugs. DAWS includes a severe stereotypical cluster of psychiatric and psychological symptoms encompa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/12/2/219 |
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| author | Paolo Solla Tommaso Ercoli Carla Masala Gianni Orofino Laura Fadda Davide Giacomo Corda Ignazio Roberto Zarbo Mario Meloni Elia Sechi Caterina Francesca Bagella Giovanni Defazio |
| author_facet | Paolo Solla Tommaso Ercoli Carla Masala Gianni Orofino Laura Fadda Davide Giacomo Corda Ignazio Roberto Zarbo Mario Meloni Elia Sechi Caterina Francesca Bagella Giovanni Defazio |
| author_sort | Paolo Solla |
| collection | DOAJ |
| description | Parkinson’s disease (PD) patients using dopamine agonists can develop withdrawal symptoms, referred to as dopamine agonist withdrawal syndrome (DAWS), under dose tapering or discontinuation of these drugs. DAWS includes a severe stereotypical cluster of psychiatric and psychological symptoms encompassing severe mood and anxiety disturbances, autonomic symptoms, as well as generalized pain and drug cravings. However, symptoms of withdrawal of dopamine replacement therapies (DRT) are not simply limited to dopamine agonists tapering, as observed in PD patients on deep brain stimulation after dopaminergic drugs withdrawal related to surgery. To date, no DRT-related withdrawal syndrome has been described in PD patients who discontinue rasagiline, an irreversible inhibitor of monoamine oxidase-B (MAO-B). Here we report three PD patients who developed a severe withdrawal syndrome after rasagiline suspension. The syndrome was mainly characterized by prominent psychiatric disorders (depression, anxiety with panic attacks, dysphoria, and agitation) associated with fatigue, generalized pain, and autonomic manifestations (closely resembling symptoms of DAWS). In our opinion, this report suggests the importance of closely monitoring PD patients undergoing rasagiline suspension for withdrawal symptoms and provides interesting points of reflection on the role of rasagiline and other MAO-B inhibitors in mood disorders. |
| first_indexed | 2024-03-09T22:26:46Z |
| format | Article |
| id | doaj.art-2af45ad726a04c3b929c5904a6e2f5fc |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T22:26:46Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-2af45ad726a04c3b929c5904a6e2f5fc2023-11-23T19:03:26ZengMDPI AGBrain Sciences2076-34252022-02-0112221910.3390/brainsci12020219Rasagiline Withdrawal Syndrome in Parkinson’s DiseasePaolo Solla0Tommaso Ercoli1Carla Masala2Gianni Orofino3Laura Fadda4Davide Giacomo Corda5Ignazio Roberto Zarbo6Mario Meloni7Elia Sechi8Caterina Francesca Bagella9Giovanni Defazio10Unit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyDepartment of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, ItalyDepartment of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, ItalyDepartment of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, ItalyDepartment of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, ItalyUnit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyUnit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyIRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, ItalyUnit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyUnit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyDepartment of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari, SS 554 km 4.500, 09042 Cagliari, ItalyParkinson’s disease (PD) patients using dopamine agonists can develop withdrawal symptoms, referred to as dopamine agonist withdrawal syndrome (DAWS), under dose tapering or discontinuation of these drugs. DAWS includes a severe stereotypical cluster of psychiatric and psychological symptoms encompassing severe mood and anxiety disturbances, autonomic symptoms, as well as generalized pain and drug cravings. However, symptoms of withdrawal of dopamine replacement therapies (DRT) are not simply limited to dopamine agonists tapering, as observed in PD patients on deep brain stimulation after dopaminergic drugs withdrawal related to surgery. To date, no DRT-related withdrawal syndrome has been described in PD patients who discontinue rasagiline, an irreversible inhibitor of monoamine oxidase-B (MAO-B). Here we report three PD patients who developed a severe withdrawal syndrome after rasagiline suspension. The syndrome was mainly characterized by prominent psychiatric disorders (depression, anxiety with panic attacks, dysphoria, and agitation) associated with fatigue, generalized pain, and autonomic manifestations (closely resembling symptoms of DAWS). In our opinion, this report suggests the importance of closely monitoring PD patients undergoing rasagiline suspension for withdrawal symptoms and provides interesting points of reflection on the role of rasagiline and other MAO-B inhibitors in mood disorders.https://www.mdpi.com/2076-3425/12/2/219rasagilineDAWSParkinson’s disease |
| spellingShingle | Paolo Solla Tommaso Ercoli Carla Masala Gianni Orofino Laura Fadda Davide Giacomo Corda Ignazio Roberto Zarbo Mario Meloni Elia Sechi Caterina Francesca Bagella Giovanni Defazio Rasagiline Withdrawal Syndrome in Parkinson’s Disease Brain Sciences rasagiline DAWS Parkinson’s disease |
| title | Rasagiline Withdrawal Syndrome in Parkinson’s Disease |
| title_full | Rasagiline Withdrawal Syndrome in Parkinson’s Disease |
| title_fullStr | Rasagiline Withdrawal Syndrome in Parkinson’s Disease |
| title_full_unstemmed | Rasagiline Withdrawal Syndrome in Parkinson’s Disease |
| title_short | Rasagiline Withdrawal Syndrome in Parkinson’s Disease |
| title_sort | rasagiline withdrawal syndrome in parkinson s disease |
| topic | rasagiline DAWS Parkinson’s disease |
| url | https://www.mdpi.com/2076-3425/12/2/219 |
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