Session Information
Date: Wednesday, June 22, 2016
Session Title: Rating scales
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To describe the development of the dopamine agonist withdrawal syndrome (DAWS) rating scale (DAWS-RS), a new questionnaire designed to evaluate the symptoms, severity, and secondary consequences of DAWS.
Background: DAWS is a severe drug withdrawal syndrome characterized by symptoms such as anxiety, depression, fatigue, orthostatic hypotension, nausea/vomiting, and drug cravings. DAWS occurs in 15-19% of people with Parkinson’s disease (PD) who taper a dopamine agonist, and may be so severe that patients are unable to discontinue the drug. This can result in chronic dopamine agonist-related impulse control disorders (ICDs) in some patients. Current challenges in the clinical management of DAWS include underreporting, underrecognition, and misdiagnosis of symptoms. At present, there is no validated clinical instrument to evaluate and monitor DAWS.
Methods: A new 21-item scale for the assessment of DAWS in PD was developed based on detailed literature review and feedback from movement disorders specialists, PD patients, and healthy control subjects.
Results: The DAWS-RS comprises five domains: (1) anxiety and depression; (2) sleep and fatigue; (3) other psychiatric symptoms; (4) gastrointestinal, autonomic, and pain symptoms; and (5) impact on social and occupational functioning. Each question is given a score from 0-3, based on symptom frequency and severity. The scale is self-rated and self-administered. It was piloted on an unselected sample of sixty-four PD patients without DAWS (ages 36-84; 42% female; modified Hoehn and Yahr stages 1-3; disease duration 1-18 years; Montreal Cognitive Assessment scores 19-30). Subjects were able to complete the DAWS-RS in 2-4 minutes, with a median score of 9 (interquartile range 4-13) out of a maximum of 63.
Conclusions: The DAWS-RS is a brief tool that has the potential to facilitate the identification and quantitation of DAWS symptoms in research and clinical settings. The next step will be to validate and evaluate the clinimetric properties of the DAWS-RS in a large, multicenter cohort of PD patients with and without DAWS.
Not previously presented, but has also been submitted to American Academy of Neurology (2016 meeting).
To cite this abstract in AMA style:
L.S. Croll, K.M. Montgomery, C.V. Kulick, M.J. Nirenberg. The dopamine agonist withdrawal syndrome rating scale (DAWS-RS): Initial development of a new non-motor scale [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/the-dopamine-agonist-withdrawal-syndrome-rating-scale-daws-rs-initial-development-of-a-new-non-motor-scale/. Accessed May 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-dopamine-agonist-withdrawal-syndrome-rating-scale-daws-rs-initial-development-of-a-new-non-motor-scale/