Dopamine Dysregulation Syndrome

Dopamine is a naturally occurring organic chemical in the brain that acts as both a hormone and a neurotransmitter. Among other processes, dopamine controls reward-motivated behaviour and the anticipation of reward, which increases the release of dopamine. Dopamine also determines the desirability of outcomes associated with particular behaviours or actions.

Several addictive psychoactive drugs, such as opioids, increase the production of dopamine or block its reuptake into the brain. Consequently, taking psychoactive drugs can disrupt the natural processes of reward-motivated behaviour.

What Is Dopamine Dysregulation Syndrome?

Dopamine dysregulation syndrome is most frequently experienced by individuals who take dopaminergic drugs or medication for extended time periods. The syndrome is a dysfunction of the brain’s reward system.

If an individual has become dependent on psychoactive drugs, it is likely that the brain has ceased the production of naturally occurring dopamine. If the brain does not create dopamine, it is likely for depression to arise; therefore, the brain’s reward system craves artificial dopamine sources such as drugs and medications.

Additionally, naturally occurring dopamine does not create the same high that drugs can produce, and subsequently the brain becomes addicted to a more intense experience of pleasure and euphoria.

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Types of Dopamine Dysregulation Syndrome

One of the most frequently observed types of dopamine dysregulation syndrome is Parkinson’s-related dopamine dysregulation syndrome. Parkinson’s disease causes a degeneration of dopamine neurons and a loss of dopamine in the putamen. Therefore, the medications used to treat the disease alter dopamine in the brain, and patients can develop a compulsive craving to take the medication even if there is no obvious need to.

The other most common type of dopamine dysregulation syndrome is caused by drug abuse. Similarly to Parkinson’s medication, many addictive psychoactive drugs such as opioids artificially increase the production of dopamine in the brain. The repeated use of these drugs causes the brain to stop creating dopamine naturally, and so the individual begins to crave dopamine agonist drugs.

Causes of Dopamine Dysregulation Syndrome

In some cases, the regulation of dopamine is impacted by involuntarily occurring diseases such as Parkinson’s that cause a degeneration of the brain’s reward system, although often dopamine dysregulation syndrome is caused by the use of drugs or misuse of medication.

Opioids such as heroin or fentanyl bind to opioid receptors in the central nervous system, which are responsible for the production of naturally occurring pleasurable hormones such as endorphins and dopamine. Opioid drugs artificially induce the production of dopamine; however, they create a more intense high than natural hormones. Consequently, repeatedly using opioids causes the brain to stop creating dopamine and crave dopaminergic drugs in order to experience that same level of high.

Symptoms of Dopamine Dysregulation Syndrome

The most obvious sign of dopamine dysregulation syndrome is the craving for dopaminergic medication. Intense cravings for medication can manifest themselves in aggressive outbursts, bribery and out-of-character behaviour.

Dopamine dysregulation syndrome can also cause behavioural symptoms that may accompany craving symptoms or be present independently. Behavioural symptoms include hypomania, which often manifests through feelings of euphoria or omnipotence, dysphorias such as extreme sadness, psychomotor slowing, fatigue and psychosis.

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