Would Augmentation Occur in Healthy Controls & Parkinson’s

[Oozz]

I’ve had some thoughts about augmentation and was hoping I could get some feedback. I’m trying to understand if only dopamine dysfunction could be the root cause and end-point for some people.

If I gave pramipaxole to my girlfriend who does not have RLS, would she eventually develop some form of augmentation? Or, does that mechanism only exist because we have RLS? Theoretically, she would develop the same up regulation and down regulation that causes RLS, right?

Similarly, do Parkinson’s patient’s experience augmentation? And, at similar rates? Please correct me if I am wrong, but a Parkinson’s patient would experiene RLS due to hypodopamanergic state? This is in contrast to other RLS which is largely theorized to be due to hyperdopaminergic state.

[Rustsmith]

I do not know about augmentation in a healthy control, but it does not occur in Parkinsons. Dopamine agonists are routinely used to treat Parkinsons and augmentation is not an issue even though they take much higher doses than we do. They can, and do, develop impulse control disorders as a result of taking dopamine at this occurs at about the same frequency as it does for RLS patients.

[Oozz]

Thanks. After looking at this myself, it seems that is a strong argument that RLS in PD is caused by the use of dopamine agonists. When looking at RLS rates in PD patients prior to DA treatment, there is not a higher prevalence. However the data is not 100% conclusive.