Continuous Subcutaneous Apomorphine as a Temporary Bridging Therapy for Dopamine Dysregulation Syndrome in Patients with Deep Brain Stimulation.

Authors

Tobias Binder, Johannes Hartig, Lennart Sitzmann, Chi Wang Ip, Philipp Capetian, Florian Lange, Martin Reich, Christine Daniels, Jens Volkmann

Published in

Movement disorders clinical practice. Oct 08, 2026. Epub Oct 08, 2026.

Abstract

Dopamine dysregulation syndrome (DDS) is a challenging complication of dopaminergic therapy in Parkinson's disease and can persist despite subthalamic deep brain stimulation (STN-DBS). We evaluated a temporary bridging concept in which oral dopaminergic medication was replaced by continuous subcutaneous apomorphine infusion while maintaining DBS.
Six patients with STN-DBS and DDS were temporarily transitioned from oral dopaminergic medication to continuous subcutaneous apomorphine infusion. Treatment success was defined as reduction of DDS below a predefined threshold (<3 characteristic DDS features). Four of six patients (66.7%) no longer fulfilled the operational DDS criteria. Typical apomorphine-related adverse effects occurred in all patients; however, nausea and malaise limited the treatment in two non-responders.
In this uncontrolled case series, continuous subcutaneous apomorphine may represent a useful temporary adjunct to STN-DBS for managing DDS in selected patients. Treatment tolerability appears to be a major determinant of success and requires careful patient selection and monitoring.

PMID:
42845107
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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