title: Clinical spectrum of impulse control disorders in Parkinson's disease.
abstract: Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa. Possible risk factors for ICDs include male sex, younger age and younger age at PD onset, a pre-PD history of ICDs, and a personal or family history of substance abuse, bipolar disorder, or gambling problems. Given the paucity of treatment options and potentially serious consequences, it is critical for PD patients to be monitored closely for development of ICDs as part of routine clinical care.
authors.affiliation: Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Evans
authors.forename: Jon E
authors.initials: JE
authors.lastname: Grant
authors.forename: Mark
authors.initials: M
authors.lastname: Stacy
mesh_terms: D000818:Animals; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D003192:Compulsive Behavior / Q000175:diagnosis / Q000188:drug therapy*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004298:Dopamine / Q000378:metabolism; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*
chemical_list: D018491:Dopamine Agonists; D004298:Dopamine
keywords: Parkinson's disease; dopamine agonists; impulse control disorder