title: Addictive behaviors and Parkinson's disease.
abstract: BACKGROUND
  In Parkinson's disease, the degeneration of the dopaminergic system and the longstanding exposure to dopamine replacement therapy (DRT) may cause, in a group of vulnerable patients, dysregulation of the brain reward system.
  
  
  BACKGROUND
  These patients develop DRT-related compulsions, which include addiction to levodopa or dopamine dysregulation syndrome (DDS), punding, and impulse control disorders (ICDs). ICDs or behavioral addiction reported in Parkinson's disease include pathological gambling, hypersexuality, compulsive buying and binge eating. Although the underlying pathophysiology is still poorly understood, these behaviors are linked by their reward-based and repetitive nature. Such behaviors may result in devastating psychosocial impairment for the patients and are often hidden.
  The recognition of these behaviors is important and allows a better clinical management. Although the limited data do not permit particular therapeutic strategies, some approaches are worth considering: DRT reduction, trials of non-dopaminergic medications and subthalamic chronic stimulation.
authors.affiliation: Service de neurologie et pathologie du mouvement, hôpital de la Timone, Marseille cedex, France. tatiana.witjas@ap-hm.fr
authors.forename: T
authors.initials: T
authors.lastname: Witjas
authors.forename: A
authors.initials: A
authors.lastname: Eusebio
authors.forename: F
authors.initials: F
authors.lastname: Fluchère
authors.forename: J-P
authors.initials: JP
authors.lastname: Azulay
mesh_terms: D016739:Behavior, Addictive / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D003192:Compulsive Behavior / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000628:therapy; D004298:Dopamine / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008954:Models, Biological; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D012201:Reward
chemical_list: D004298:Dopamine