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Master Thesis

État des lieux par les psychiatres et les neurologues de la prise en charge des troubles du contrôle des impulsions et comportements hyperdopaminergiques associés dans la maladie de Parkinson

Abstract : Background: impulse control disorders (ICD) in Parkinson’s disease patients may be promoted by dopamine therapy used to control Parkinson disease (PD). The coexistence of motor, behavioral and cognitive symptoms diminishes the wide range of treatment options, sometimes leaving the clinician with very little option between good motor status and satisfactory behavioral compensation. There is insufficient evidence to recommend one treatment over another. The objective of this study was to analyze the management of ICD and associated hyperdopaminergic behaviors in PD patients by retracing the different practices that are used throughout France in order to try to harmonize them, something that has never been done before.
Methods: this is a descriptive observational study carried out using two questionnaires carried out on Google form, sent electronically to neurologists and psychiatrists taking or having already cared for PD patients with ICD, employees or liberal, practicing in mainland France. The differences were considered significant when the p-value was ≤ 0.05.
Results: 47 neurologists and 12 psychiatrists answered the questionnaires. The answers generally tend towards what we find in the literature. The first measure considered by the two groups is to reduce the dosage of dopamine agonists (p <0.001). If the adaptation of the designated treatment is not sufficient, in the vast majority of cases they recommend the use of an atypical antipsychotic. Many variables must be taken into account throughout the treatment, whether it is for the choice of the drug considered, the waiting time before reassessment of the patient's clinical condition ... The management would rather be multidisciplinary.
Conclusion: it is difficult to generalize therapeutic choices depending very largely on a very large number of factors, which makes an overall response in a questionnaire very difficult. This study has attempted to draw a general guideline in order to help clinicians involved in the management of ICD in PD, to standardize their practice. The results are broadly consistent with the data in the literature but to date there is insufficient evidence to support or refute the efficacy of the above treatments in improving ICD in PD.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03373257
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Monday, October 11, 2021 - 2:06:12 PM
Last modification on : Tuesday, December 7, 2021 - 4:10:59 PM
Long-term archiving on: : Wednesday, January 12, 2022 - 7:52:09 PM

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2021NICEM082.pdf
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  • HAL Id : dumas-03373257, version 1

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Victoria Gillet. État des lieux par les psychiatres et les neurologues de la prise en charge des troubles du contrôle des impulsions et comportements hyperdopaminergiques associés dans la maladie de Parkinson. Médecine humaine et pathologie. 2021. ⟨dumas-03373257⟩

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