{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:16:09Z","timestamp":1773422169661,"version":"3.50.1"},"reference-count":28,"publisher":"American Society of Consultant Pharmacists","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:p>This case study examines how patients with Parkinson\u2019s disease (PD) may develop dopamine dysregulation syndrome (DDS), a condition characterized by the misuse of dopamine replacement therapy through excessive self-directed dosing beyond what is necessary to control motor symptoms.\n While carbidopa\/levodopa remains the mainstay therapy for many adults with PD, some patients may choose Mucuna pruriens, a complementary medicine containing levodopa, to manage their motor symptoms. This case describes a patient with PD who presents with DDS following co-administration of\n self-directed Mucuna pruriens alongside extended-release (ER) and immediate-release (IR) carbidopa\/levodopa. Recognizing the presentation and risk factors of DDS is crucial, as is educating and monitoring patients with PD to prevent misuse of both their prescribed dopamine replacement therapy\n and Mucuna pruriens supplements.<\/jats:p>","DOI":"10.4140\/tcp.n.2025.450","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:40:15Z","timestamp":1762958415000},"page":"450-456","source":"Crossref","is-referenced-by-count":2,"title":["Dopamine Dysregulation Syndrome in Parkinson\u2019s Disease"],"prefix":"10.4140","volume":"40","author":[{"given":"Audrey J.","family":"Lee","sequence":"first","affiliation":[{"name":"1Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda H.","family":"Poon","sequence":"additional","affiliation":[{"name":"1Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, California."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","year":"2025"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2165\/00023210-200923020-00005","article-title":"Dopamine dysregulation syndrome: an overview of its epidemiology, mechanisms, and management","volume":"23","year":"2009","journal-title":"CNS Drugs"},{"issue":"20","key":"ref3","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1212\/WNL.0000000000012868","article-title":"Guideline Subcommittee of the AAN. Dopaminergic therapy for motor symptoms in early Parkinson disease practice guideline summary: a report of the AAN Guideline Subcommittee","volume":"97","year":"2021","journal-title":"Neurology"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"106983","DOI":"10.1016\/j.parkreldis.2024.106983","article-title":"Mucuna pruriens to treat Parkinson\u2019s disease in low-income countries: recommendations and practical guidelines from the farmer to clinical trials","volume":"124","year":"2024","journal-title":"Parkinsonism Relat Disord"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1001\/jamaneurol.2022.2184","article-title":"Levodopa content of Mucuna pruriens supplements in the NIH Dietary Supplement Label Database","volume":"79","year":"2022","journal-title":"JAMA Neurol."},{"key":"ref6","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.biopha.2017.05.137","article-title":"Important medicinal herbs in Parkinson\u2019s disease pharmacotherapy","volume":"92","year":"2017","journal-title":"Biomed Pharmacother."},{"issue":"4","key":"ref7","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S2225-4110(16)30119-5","article-title":"The magic velvet bean of Mucuna pruriens","volume":"2","year":"2012","journal-title":"J Tradit Complement Med."},{"issue":"12","key":"ref8","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/s13205-020-02532-7","article-title":"Mucuna pruriens in Parkinson\u2019s and in some other diseases: recent advancement and future prospective","volume":"10","year":"2020","journal-title":"3 Biotech"},{"issue":"8","key":"ref9","doi-asserted-by":"crossref","first-page":"3208","DOI":"10.1016\/j.apsb.2023.06.009","article-title":"The neuroprotective effect of traditional Chinese medicinal plants: a critical review","volume":"13","year":"2023","journal-title":"Acta Pharm Sin B"},{"issue":"5","key":"ref10","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1212\/WNL.0000000000004175","article-title":"Mucuna pruriens in Parkinson disease: a double-blind, randomized, controlled, crossover study","volume":"89","year":"2017","journal-title":"Neurology."},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1089\/acm.2017.0054","article-title":"Analysis of levodopa content in commercial Mucuna pruriens products using high-performance liquid chromatography with fluorescence detection","volume":"24","year":"2018","journal-title":"J Altern Complement Med."},{"issue":"5","key":"ref12","first-page":"157","article-title":"Case of levodopa toxicity from ingestion of Mucuna gigantea","volume":"72","year":"2013","journal-title":"Hawaii J Med Public Health"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.wem.2021.10.004","article-title":"Poisoning after ingestion of Mucuna pruriens seeds on Reunion Island","volume":"33","year":"2022","journal-title":"Wilderness Environ Med."},{"issue":"4","key":"ref14","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/01.wco.0000137528.23126.41","article-title":"Dopamine dysregulation syndrome in Parkinson\u2019s disease","volume":"17","year":"2004","journal-title":"Curr Opin Neurol."},{"issue":"11","key":"ref15","first-page":"1060","article-title":"Dopamine dysregulation syndrome in Parkinson\u2019s disease: a systematic review of published cases","volume":"88","year":"2017","journal-title":"J Neurol Neurosurg Psychiatry."},{"issue":"2","key":"ref16","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1002\/mds.29700","article-title":"Management of impulse control and related disorders in Parkinson\u2019s disease: an expert consensus","volume":"39","year":"2024","journal-title":"Mov Disord."},{"issue":"12","key":"ref17","first-page":"4333","article-title":"Predictors of dopamine dysregulation syndrome in patients with early Parkinson\u2019s disease","volume":"44","year":"2023","journal-title":"Neurol Sci."},{"issue":"5","key":"ref18","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/mdc3.12671","article-title":"The outcome of dopamine dysregulation syndrome in Parkinson\u2019s disease: a retrospective postmortem study","volume":"5","year":"2018","journal-title":"Mov Disord Clin Pract."},{"issue":"3","key":"ref19","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1002\/mdc3.13154","article-title":"Advanced therapies for the management of dopamine dysregulation syndrome in Parkinson\u2019s disease","volume":"8","year":"2021","journal-title":"Mov Disord Clin Pract."},{"key":"ref20","article-title":"(carbidopa and levodopa) [package insert]","year":"2014","journal-title":"Whitehouse Station"},{"key":"ref21","article-title":"Bridgewater","year":"2019","journal-title":"NJ: Amneal Pharmaceuticals LLC"},{"key":"ref22","year":"2024","journal-title":"Bridgewater, NJ: Amneal Pharmaceuticals LLC"},{"key":"ref23","year":"2021","journal-title":"Riverside Pharmaceutical Corporation"},{"key":"ref24","year":"2025","journal-title":"Rytary"},{"issue":"2","key":"ref25","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1212\/CPJ.0000000000000438","volume":"8","year":"2018","journal-title":"Neurol Clin Pract."},{"key":"ref26","year":"2024","journal-title":"IL: AbbVie Inc"},{"key":"ref27","year":"2024","journal-title":"IL: AbbVie Inc"},{"key":"ref28","year":"2022","journal-title":"NY: Acorda Therapeutics Inc"}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2025\/00000040\/00000011\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:40:27Z","timestamp":1762958427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2025.450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"alternative-id":["2639-9636(20251101)40:11L.450;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2025.450","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}