Impulse control disorders and dopamine dysregulation syndrome associated with dopamine agonist therapy in Parkinson's disease.
Over the last decade, evidence has emerged linking disorders in the impulsive-compulsive spectrum in Parkinson's disease to dopamine receptor agonist treatment. These disorders include hypersexuality, gambling and, to a minor extent, compulsive shopping and eating, as well as dopamine dysregulation syndrome, characterized by an addictive pattern toward dopamine replacement therapy and stereotyped behaviors, such as punding. These syndromes, which have only recently been recognized and are still underdiagnosed, have deleterious social consequences that warrant interventions at the clinical level and promotion of research at the preclinical level. In this review, we first provide a summary of features of Parkinson's disease and current pharmacological therapies associated with the development of dopamine dysregulation syndrome and impulsive-compulsive disorders. We also examine the dopamine receptors and brain areas important in reward and compulsive behaviors. We then critically examine the neuroadaptations in dopaminergic circuitries and the literature concerning gambling, hypersexuality, and other addictive behaviors in parkinsonian patients. Finally, we focus on suggestions pointing to a role for dopamine D(3) receptors and sensitization phenomena as the main factors which may be the origin of these disorders.
Fenu
Sandro
S
Department of Toxicology, National Institute of Neuroscience and Centre of Excellence for Studies on the Neurobiology of Addiction, University of Cagliari, Cagliari, Italy.
Wardas
Jadwiga
J
Morelli
Micaela
M
D000818:Animals; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000378:metabolism*; D004298:Dopamine / Q000378:metabolism*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D008659:Metabolic Diseases / Q000150:complications / Q000378:metabolism*; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*
D018491:Dopamine Agonists; D004298:Dopamine