title: Management of impulse control disorders in Parkinson's disease: Controversies and future approaches.
abstract: Impulse control disorders in Parkinson's disease are a group of impulsive behaviors most often associated with dopaminergic treatment. Presently, there is a lack of high quality evidence available to guide their management. This manuscript reviews current management strategies, before concentrating on the concept of dopamine agonist withdrawal syndrome and its implications for the management of impulse control disorders. Further, we focus on controversies, including the role of more recently available anti-parkinsonian drugs, and potential future approaches involving routes of drug delivery, nonpharmacological treatments (such as cognitive behavioral therapy and deep brain stimulation), and other as yet experimental strategies.
authors.affiliation: Department of Neurology, National Parkinson Foundation International Centre of Excellence, King's College Hospital, King's Health Partners, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Samuel
authors.forename: Maria
authors.initials: M
authors.lastname: Rodriguez-Oroz
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Brotchie
authors.forename: Kallol
authors.initials: K
authors.lastname: Ray Chaudhuri
authors.forename: Richard G
authors.initials: RG
authors.lastname: Brown
authors.forename: Wendy R
authors.initials: WR
authors.lastname: Galpern
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Nirenberg
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
mesh_terms: D000818:Animals; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D046690:Deep Brain Stimulation / Q000379:methods; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications / Q000628:therapy*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D007175:Impulsive Behavior / Q000187:drug effects / Q000502:physiology; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists
keywords: Clinical Trials; Deep Brain Stimulation; Dopamine Agonist Withdrawal; Impulse control; Management; Parkinson's