scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Impulse control disorders in patients with hyperpolactinemia treated with dopamine agonists: how much should we worry?

2018 ◽  
Vol 179 (6) ◽  
pp. R287-R296 ◽  
Author(s):  
Maya Barake ◽  
Anne Klibanski ◽  
Nicholas A Tritos
Keyword(s):  
Impulse Control ◽  
Dopamine Agonists ◽  
Well Being ◽  
Review Article ◽  
Impulse Control Disorders ◽  
Endocrine Disease ◽  
Compulsive Shopping ◽  
Neurologic Disorders ◽  
Pathologic Gambling ◽  
Pathophysiologic Mechanisms

Dopamine agonists (DAs) represent a cornerstone in the management of patients with hyperprolactinemia and have an important role in the treatment of neurologic disorders, including Parkinson’s disease and restless legs syndrome. A growing body of evidence has identified impulse control disorders (ICDs) as possible adverse effects of DA therapy. A variety of ICDs may occur in patients treated with DA, including compulsive shopping, pathologic gambling, stealing, hypersexuality and punding (repetitive performance of tasks, such as collecting, sorting, disassembling and assembling objects). These behaviors can have devastating effects on patients’ life and family. In the present review article, we summarize available data on ICDs in patients with hyperprolactinemia as well as other disorders. Possible risk factors for the emergence of ICDs in patients treated with DA are discussed and the putative pathophysiologic mechanisms underlying the development of ICDs in this setting are reviewed. In addition, strategies for the early identification and management of ICDs in patients on DA are discussed. In conclusion, a wide variety of ICDs can occur in patients treated with DA, including those with hyperprolactinemia. The development of ICDs can have serious implications for patients’ well-being and family. Endocrinologists and other physicians involved in the care of patients on DA therapy must be aware of this potential adverse effect, counsel patients regarding pertinent symptoms and regularly evaluate treated patients for the development of ICDs. Early detection of ICDs and discontinuation of DA therapy can mitigate the potential harms associated with ICDs in these patients.

scholarly journals Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson’s Disease Population

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1263
Author(s):  
Mauricio Iván García-Rubio ◽  
María Elisa Otero-Cerdeira ◽  
Christian Gabriel Toledo-Lozano ◽  
Sofía Lizeth Alcaraz-Estrada ◽  
Juan Antonio Suárez-Cuenca ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Binge Eating ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Protective Factor ◽  
Impulse Control Disorders ◽  
Compulsive Shopping ◽  
Factors Associated ◽  
Clinical Records

Parkinson’s disease (PD) is a neurodegenerative disease in which non-motor symptoms may appear before motor phenomena, which include Impulse Control Disorders (ICDs). The objective of this study is to identify factors associated with the development of ICDs in PD. An analytical, cross-sectional study was conducted using clinical records from patients diagnosed with PD, both genders, from 40 to 80 years old. Clinical and demographic data were collected: 181 patients were recruited; 80 of them showed PD and ICDs, and they constituted the study group, whereas 101 patients with PD without ICDs constituted the control reference group. The duration of PD was longer in the group with ICDs (p < 0.008), and all patients showed at least one ICD: binge eating (61.29%), compulsive shopping (48.75%), hypersexuality (23.75%), gambling behavior (8.75%), and punding (3.75%). After logistic regression analysis, only the use of dopamine agonists remained associated with ICDs (p < 0.001), and the tremorgenic form was suggested to be a protective factor (p < 0.001). Positive associations were observed between the rigid-akinetic form and compulsive shopping (p < 0.007), between male and hypersexuality (p < 0.018), and between dopamine agonists and compulsive shopping (p < 0.004), and negative associations were observed between motor fluctuations and compulsive shopping (p < 0.031), between Deep Brain Stimulation and binge eating (p < 0.046), and between levodopa consumption and binge eating (p < 0.045). Binge eating, compulsive shopping, and hypersexuality were the most frequent ICDs. Complex forms and motor complications of PD were associated with the development of ICDs.

New Dimensions in the OCD Spectrum: Autism, Pathologic Gambling, and Compulsive Buying

CNS Spectrums ◽  
1996 ◽  
Vol 1 (2) ◽  
pp. 44-53
Author(s):  
Cheryl M. Wong ◽  
Eric Hollander
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Treatment Options ◽  
Compulsive Buying ◽  
Health Problems ◽  
Obsessive Compulsive ◽  
Compulsive Shopping ◽  
Neurologic Disorders ◽  
Pathologic Gambling

AbstractThe obsessive-compulsive spectrum can be divided into two subclusters: disorders of impulsivity and neurologic disorders (Figure 1). This article examines autism (from the neurologic cluster) and pathologic gambling and compulsive shopping (from the impulse side of the spectrum). These three disorders are major mental health problems, impacting on society, the affected individuals, and their families. In addition, these three disorders are underrecognized and underdiagnosed. In this article, we outline and review the phenomenology, psychopathology, and treatment options of these three disorders.

scholarly journals Dopamine and reward hypersensitivity in Parkinson’s disease with impulse control disorder

Brain ◽  
2020 ◽  
Vol 143 (8) ◽  
pp. 2502-2518
Author(s):  
Daniel S Drew ◽  
Kinan Muhammed ◽  
Fahd Baig ◽  
Mark Kelly ◽  
Youssuf Saleh ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Impulse Control Disorders ◽  
Reward Sensitivity ◽  
Impulse Control Disorder ◽  
Dopaminergic Medication ◽  
Neuropsychiatric Complications ◽  
Pupillary Responses

Abstract Impulse control disorders in Parkinson’s disease are common neuropsychiatric complications associated with dopamine replacement therapy. Some patients treated with dopamine agonists develop pathological behaviours, such as gambling, compulsive eating, shopping, or disinhibited sexual behaviours, which can have a severe impact on their lives and that of their families. In this study we investigated whether hypersensitivity to reward might contribute to these pathological behaviours and how this is influenced by dopaminergic medication. We asked participants to shift their gaze to a visual target as quickly as possible, in order to obtain reward. Critically, the reward incentive on offer varied over trials. Motivational effects were indexed by pupillometry and saccadic velocity, and patients were tested ON and OFF dopaminergic medication, allowing us to measure the effect of dopaminergic medication changes on reward sensitivity. Twenty-three Parkinson’s disease patients with a history of impulse control disorders were compared to 26 patients without such behaviours, and 31 elderly healthy controls. Intriguingly, behavioural apathy was reported alongside impulsivity in the majority of patients with impulse control disorders. Individuals with impulse control disorders also exhibited heightened sensitivity to exogenous monetary rewards cues both ON and OFF (overnight withdrawal) dopamine medication, as indexed by pupillary dilation in anticipation of reward. Being OFF dopaminergic medication overnight did not modulate pupillary reward sensitivity in impulse control disorder patients, whereas in control patients reward sensitivity was significantly reduced when OFF dopamine. These effects were independent of cognitive impairment or total levodopa equivalent dose. Although dopamine agonist dose did modulate pupillary responses to reward, the pattern of results was replicated even when patients with impulse control disorders on dopamine agonists were excluded from the analysis. The findings suggest that hypersensitivity to rewards might be a contributing factor to the development of impulse control disorders in Parkinson’s disease. However, there was no difference in reward sensitivity between patient groups when ON dopamine medication, suggesting that impulse control disorders may not emerge simply because of a direct effect of dopaminergic drug level on reward sensitivity. The pupillary reward sensitivity measure described here provides a means to differentiate, using a physiological measure, Parkinson’s disease patients with impulse control disorder from those who do not experience such symptoms. Moreover, follow-up of control patients indicated that increased pupillary modulation by reward can be predictive of the risk of future emergence of impulse control disorders and may thereby provide the potential for early identification of patients who are more likely to develop these symptoms.

scholarly journals The risky business of dopamine agonists in Parkinson disease and impulse control disorders.

2011 ◽  
Vol 125 (4) ◽  
pp. 492-500 ◽  
Author(s):  
Daniel O. Claassen ◽  
Wery P. M. van den Wildenberg ◽  
K. Richard Ridderinkhof ◽  
Charles K. Jessup ◽  
Madaline B. Harrison ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Impulse Control Disorders ◽  
Risky Business

“He Wants It All the Time, Doctor”

2016 ◽  
Author(s):  
Robertus M. A. de Bie
Keyword(s):  
Behavioral Change ◽  
Impulse Control ◽  
Disease Onset ◽  
Impulse Control Disorders ◽  
Dopaminergic Therapy ◽  
Compulsive Shopping ◽  
Compulsive Eating ◽  
Dopamine Dysregulation Syndrome ◽  
Factors Associated ◽  
History Of

Impulse-control disorders are an increasingly recognized complication of dopaminergic therapy in Parkinson’s disease, being present in approximately 15% of patients treated with dopamine agonists but also observed in patients treated with levodopa (referred to as “dopamine dysregulation syndrome”). Impulse-control disorders include pathological gambling, hypersexuality, compulsive shopping, and compulsive eating. Factors associated with a higher risk for impulse-control disorders are a young age at disease onset, a history of addictive behavior before the disease started, a family history of addiction such as alcoholism, and being male. It is undoubtedly true that current estimates are conservative due to embarrassment or shame preventing patients from disclosing behavioral change to their doctors. All patients must be questioned about impulse-control disorders at every visit, and where possible a collateral should be obtained from a family member or carer.

scholarly journals Non-motor symptom burden in patients with Parkinson’s disease with impulse control disorders and compulsive behaviours: results from the COPPADIS cohort

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
S. Jesús ◽  
◽  
M. A. Labrador-Espinosa ◽  
A. D. Adarmes ◽  
C. Méndel-Del Barrio ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Rating Scale ◽  
Disease Onset ◽  
Impulse Control Disorders ◽  
Nonmotor Symptoms ◽  
Premorbid Personality ◽  
Validated Questionnaire

Abstract The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson’s disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose.

Impulsivity, but not dopamine agonists, explains severity of impulse control disorders in PD

2015 ◽  
Vol 357 ◽  
pp. e52
Author(s):  
J. Marin-Lahoz ◽  
J. Pagonabarraga ◽  
R. Fernandez-de-Bobadilla ◽  
B. Pascual-Sedano ◽  
J. Perez-Perez ◽  
...  
Keyword(s):  
Impulse Control ◽  
Dopamine Agonists ◽  
Impulse Control Disorders
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