La maladie de Parkinson est la maladie neurodégénérative la plus fréquente en France (entre 100 et 125 000 cas), après la démence de type Alzheimer. La dopathérapie tient une place fondamentale parmi les traitements. Le Syndrome de Dysrégulation Dopaminergique (SDD) est une addiction médicamenteuse dopaminergique chez les patients souffrant de la maladie de Parkinson et traités par agonistes dopaminergiques. Ce syndrome s’accompagne de troubles du comportement et de manifestations addictives qui conduisent bien souvent le patient à être pris en charge en service de psychiatrie. Le traitement comprend l’adaptation du traitement dopaminergique mais aussi l’utilisation de psychotropes (antidépresseurs, régulateurs de l’humeur, neuroleptiques atypiques). Le traitement neurochirurgical par la stimulation cérébrale profonde (SCP) s’avère utile dans le traitement du SDD. L’évaluation précoce des troubles et le suivi des patients sont des points cruciaux de la prise en charge multidisciplinaire du SDD.

Parkinson's disease is the most common neurodegenerative disease in France after dementia of the Alzheimer type (between 100 and 125,000 cases). Among the treatments, dopatherapy plays a fundamental role. Dopaminergic Dysregulation Syndrome (DDS) is a dopaminergic drug addiction in patients with Parkinson's disease treated with dopamine agonists. This syndrome is associated with behavioral disorders; addictive events often lead the patient to be supported in psychiatry service. Behavioral disorders include mood disorders, high-risk behavior, impulse control disorders (punding, compulsive shopping and gambling), and hypersexuality. The pathophysiology of DDS implies the reward circuits, mainly meso-cortico-limbic dopaminergic pathway and some risk factors have been established including a history of depression and/or addiction with a possible genetic predisposition. The prevalence of this syndrome is probably underestimated due to the lack of specific measurement tools. To overcome this, the Impulsive-Compulsive Disorders in Parkinson's Disease–Rating Scale (QUIP-RS) was validated. The main treatment is the adaptation of dopaminergic therapy with rapid forms eviction and prescription of sustained-release forms. This single change in shape of treatment reduces DDS in less than 10% of cases. To improve this, the use of antidepressants appears to be a solution as shown by some studies like the use of specific inhibitors of serotonin reuptake inhibitors. The atypical neuroleptics with the administration of aripiprazole also opens perspectives in drug treatment. On neurosurgical treatment, the most currently used is deep brain stimulation. The usefulness of this treatment in DDS is observed in several studies with a significant improvement in disorders in patients who have benefited. To conclude, the patient monitoring with DDS is a crucial point of the care that must be multidisciplinary and enrolled in a comprehensive understanding of this syndrome.