Publication details

Impulse Control Disorders in patients with Parkinson’s Disease

Authors

GESCHEIDT Tomáš BAREŠ Martin

Year of publication 2011
Type Article in Periodical
Magazine / Source Acta Neurologica Belgica
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords Parkinson’s disease; impulse control disorders; pathological gambling; hypersexuality; punding; dopamine dysregulation syndrome; dopaminergic agonists
Description In patients with Parkinson’s disease with higher prevalence than in current population there appear pathological behaviours characterized by compulsion, repetitiveness and impulsivity, which are connected with material profit or pleasurable experience. They are, in particular, pathological gambling, hypersexuality, compulsive shopping and compulsive eating (in the literature they are collectively referred to as impulse control disorders). Pathological preoccupation with repeated mechanical activities (so-called punding) and excessive compulsive intake of dopaminergic medication (so-called dopamine dysregulation syndrome or also syndrome of hedonistic homeostatic dysregulation) are of similar nature. The paper treats briefly the risk factors and prevalence of these pathological behaviours. In current clinical practice, these psychiatric complications frequently escape doctors’ attention, they are underdiagnosed. Although no generally valid recommendations for their therapy are currently available, they can be influenced medically. Of advantage can be modified dopaminergic medication (usually dose reduction of dopaminergic agonists); multidisciplinary approach to the problem is appropriate. The pathological behaviours given above can frequently lead to considerable material losses and markedly aggravate patients’ handicap in the social sphere; it can be expected that in the future they can become a problem also from the ethical and legal points of view.
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