Abstract
Impulsive–compulsive behaviours (ICBs) are an increasingly well-recognised adverse-effect
of dopaminergic medications used to treat Parkinson's disease. ICBs include pathological
gambling, compulsive sexual behaviour, compulsive buying, and binge eating, together
with punding and the addiction-like compulsive use of dopamine replacement therapy,
or dopamine dysregulation syndrome. The prevalence of ICBs was approximately 14% in
a large study undertaken in specialist movement disorder clinics.
Dopamine dysregulation syndrome is more associated with compulsive l-dopa use, whereas other ICBs are more linked with oral dopamine agonist use. Other
mechanisms implicated in the development and perpetuation of ICBs in PD include aberrant
learning from reward-related situations, including decreased learning from negative
feedback, increased measures of impulsivity or sensation seeking, and strong preference
for immediate over future rewards.
Treatment options for impulsive–compulsive behaviours include pharmacological, surgical
and psychological interventions. The early recognition and prevention of ICBs, coupled
with awareness of clinical risk factors for the development of these behaviours is
of paramount importance, given the lack of specific treatments for these sometimes
debilitating behaviours.
Keywords
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Article info
Publication history
Published online: August 12, 2011
Accepted:
July 19,
2011
Received in revised form:
May 31,
2011
Received:
March 3,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
