A patient taking a dopamine agonist for Parkinson's disease (PD) or related disorder may develop excessive daytime sleepiness. These can have serious consequences if the person is driving or doing other high risk activities.


Diagnostic features:

(1) The patient is taking a dopamine agonist.

(2) The patient experiences excessive daytime sleepiness while taking the agonist.

(3) Disappearance of excessive daytime sleepiness on stopping the dopamine agonist.


Excessive daytime sleepiness may be manifest as:

(1) sleep attacks (sudden and overwhelming sleepiness without recall of having fallen asleep)

(2) excessive daytime sleepiness that occurs at inappropriate times (while holding a conversation, while actively working, while driving, while eating a meal)


Car accidents have been caused by drivers who have fallen asleep. This can be a source of liability and a patient taking a dopamine agonist should not drive if they note excessive daytime sleepiness. A person who needs to drive will need an alternative therapy.


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