Medication-related impulse control and repetitive behaviors in Parkinson's disease.
OBJECTIVE
A range of impulse control and repetitive behaviors presumed to be related to dopaminergic medications has been recognized in Parkinson's disease. These behaviors are linked by their incentive or reward-based and repetitive natures and overlap with addictions. The behaviors include pathological gambling, hypersexuality, compulsive shopping, and compulsive eating and are related to punding and compulsive medication use. In patients on dopamine agonists, these behaviors as a group are relatively common, can have potentially devastating psychosocial consequences and are commonly hidden.


RESULTS
Recent studies have investigated prevalence rates and associated factors. The literature on these behaviors in Parkinson's disease, including definitions, epidemiology, pathophysiology and management, is reviewed. The relationship to medications, Parkinson's disease and individual susceptibility is examined.


CONCLUSIONS
These behaviors can affect up to 14% of Parkinson's disease patients on dopamine agonists. Clinicians should warn patients prior to initiating dopamine agonists and enquire about these behaviors during follow up.
Voon
Valerie
V
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, Maryland 20892-1428, USA. voonv@ninds.nih.gov
Potenza
Marc N
MN
Thomsen
Teri
T
D000978:Antiparkinson Agents / Q000009:adverse effects*; D003192:Compulsive Behavior / Q000139:chemically induced*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D018491:Dopamine Agonists / Q000009:adverse effects*; D006801:Humans; D009473:Neuronal Plasticity / Q000502:physiology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D011954:Receptors, Dopamine / Q000378:metabolism; D012201:Reward; D013239:Stereotyped Behavior
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D011954:Receptors, Dopamine