For diagnosis a person with documented responsiveness to medication has to increase medication intake beyond dosage needed to relieve their parkinsonian symptoms in a pathological addiction-like pattern. A current mood disorder (depression, anxiety, hypomanic state or euphoria), behavioral disorder (excessive gambling, shopping or sexual tendency, aggression, or social isolation) or an altered perception about the effect of medication also have to be present. A questionnaire on the typical symptoms of DDS has also been developed and can help in the diagnosis process. Prevention
The main prevention measure proposed is the prescription of the lowest possible dose of dopamine replacement therapy to individuals at risk. The minimization of the use of dopamine agonists, and of short duration formulations of L-Dopa can also decrease risk of the syndrome. Management
First choice management measure consists in the enforcement of a dopaminergic drug dosage reduction. If this decrease is maintained, dysregulation syndrome features soon decrease. Cessation of dopamine agonists therapy may also be of use. Some behavioral characteristics may respond to psychotherapy; and social support is important to control risk factors. In some cases antipsychotic drugs may also be of use in the presence of psychosis, aggression, gambling or hypersexuality.Based upon five case reports, valproic acid may have efficacy in controlling the symptoms of levodopa-induced DDS that arise from the use of levodopa for the treatment of Parkinsons disease. Epidemiology
DDS is not common among PD patients. Prevalence may be around 4%. Its prevalence is higher among males with an early onset of the disease.
It is not a life-threatening disease, and it is not contagious.Dermographism may occur in mastocytosis (systemic mast cell proliferation). Diagnosis
This condition is diagnosed by a health care provider writing or drawing on the patients skin with a tongue depressor or other implement, to see whether a red wheal appears soon afterwards. Treatment
Dermographism can be treated by substances which prevent histamine from causing the reaction (i.e. an antihistamine). These may need to be given as a combination of H1 antagonists, or possibly with an H2-receptor antagonist such as cimetidine. Over-the-counter vitamin C, 1000 mg daily, increases histamine degradation and removal.Refraining from taking hot baths or showers may help if the condition is generalized (i.e. all over), as well as possibly for localized cases (i.e. in a specific area). If taking hot showers helps, it may be a condition called shower eczema. If it affects mainly the head, it may be psoriasis. In rare cases, allergy tests may uncover substances the patient is allergic to.While cromoglycate, which prevents histamine from being released from mast cells, is used topically in rhinitis and asthma, it is not effective orally for treating chronic urticaria. See also
Triple response of Lewis

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