Some people who have Parkinson’s disease (PD) will develop compulsive behaviors while receiving dopamine-replacement therapy. Known as impulse control disorders (ICDs), these behaviors may include compulsive gambling or shopping, hoarding or hyper sexuality.
What are Impulse Control Disorders?
An impulse control disorder is the inability to stop doing something that is harmful, or could become harmful, to yourself or others. Performing the harmful activity is believed to relieve anxiety and tension.
Parkinson’s Medications and Impulse Control
Currently, most of the medications for Parkinson’s — including amantadine, levodopa, pramipexole, pergolide, ropinerole, selegiline and others, as well as surgical treatments such as deep brain stimulation (DBS) — have been linked to impulse control disorders in scientific studies.
It is now confirmed that dopamine agonists are associated with impulse control disorders. Data from the U.S. Food and Drug Administration and many other sources support this association.
Remember, an impulse control disorder may be pleasurable, and therefore people experiencing it may hide the issue from friends and family. When starting dopamine agonist therapy, know how to identify ICD symptoms.
Identifying and Treating Impulse Control Disorders
If your doctor determines that you have a medication-induced ICD and the medications in question are dopamine agonists or monoamine oxidase (MAO) inhibitors (ex. Pramipaxole, Ropinirole, Rasagiline, Rotigotine patch), he or she can work with you to reduce your dosage or switch to another medication.
ICDs usually subside for people who did not experience the ICD before and developed it in relation to Parkinson’s drug. While rare, in some cases ICDs can persist despite discounting medication. In some cases, going off a medication is not an option. Your doctor will help you develop the best plan moving forward.
Page reviewed by Dr. Tracy Tholanikunnel, Assistant Professor of Movement Disorders at the University of Florida, a Parkinson’s Foundation Center of Excellence.