## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Emotional & Mental Health](/living-with-parkinsons/emotional-mental-health) ## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Emotional & Mental Health](/living-with-parkinsons/emotional-mental-health) # Impulse Control ## 💡 Quick Summary - Some people with Parkinson’s may develop impulse control disorders (ICDs), including compulsive gambling, shopping, hoarding or hypersexuality. - Dopamine-replacement medications, especially [dopamine agonists](/living-with-parkinsons/treatment/prescription-medications/dopamine-antagonists "Dopamine Agonists"), are linked to ICDs. - People with impulse control disorders may hide them because the behaviors feel pleasurable. - Identifying ICDs early and working with your doctor to adjust [medications](/living-with-parkinsons/treatment/prescription-medications "Prescription Medications") or develop a management plan can help reduce symptoms ![Casino slot machine](/sites/default/files/styles/no_sizing/public/images/impulsecontrol.jpg?itok=hKO40Yfq) 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. - ### Types of ICDs - Compulsive gambling - Compulsive shopping - Hypersexuality - Hoarding - Compulsive computer usage - ### How common are ICDs? Scientists have known for over a decade that dopamine-related drugs for Parkinson’s could be linked to ICDs. However, it was not until 2004 that people living with Parkinson’s began to learn that ICDs could be a rare side effect of dopamine agonists. In 2007, researchers at the National Institute for Neurological Diseases and Stroke (NINDS) reported that impulse control behaviors could affect up to 14 percent of Parkinson’s patients on dopamine agonists. Today, we know that one in six people taking dopamine agonists will experience impulse control disorders. - ### How serious are ICDs? For some people, impulse control disorders may be mild, or just a minor nuisance (for example, increased focus on eating sweets). For others, the impact may be more severe. People who experience compulsive gambling and compulsive shopping may lose large sums of money, even to the point of bankruptcy. Those who binge eat may experience significant weight gain, causing discomfort and embarrassment and other potential health issues. Some of those who experience compulsive sexual behaviors may begin engaging in unprotected sex or sex outside of an established relationship, placing themselves and others at risk physically and emotionally. ICDs typically impact not only the person living with PD but loved ones as well. ### 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 - ### Tips If You Suspect You May Have an ICD - Keep a drug diary and record changes in your mood or behavior, as well as physical responses. - If you find yourself starting to engage in any of the behaviors listed above or doing things that you feel guilty doing, talk to someone about it. A support group member, your doctor or someone from your place of worship are potential resources. - Let your family know what is happening because the problem affects them too. ICDs could be a significant stressor on a marriage. 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.* ## Related Materials Fact Sheets ### [ Impulse Control ](/library/fact-sheets/impulse-control) [Read Now](/library/fact-sheets/impulse-control) Podcasts ### [ Episode 92: Clinical Issues Behind Impulse Control Disorders ](/library/podcast/92) [Listen Now](/library/podcast/92) Podcasts ### [ Episode 98: How to Talk about Impulse Control Disorders ](/library/podcast/98) [Listen Now](/library/podcast/98) ## Related Blog Posts ![Woman pondering](/sites/default/files/styles/500x360/public/images/apathyimpulsecontrol-blog.jpg?h=289976fd&itok=F_g0VhTU) Science News ### [ New Study: Can People with Parkinson’s Experience Apathy and an Impulse Control Disorder at the Same Time? ](/blog/science-news/apathy) READ NOW ![gambling](/sites/default/files/styles/500x360/public/images/impulsecontrol-blog.png?h=5193ff8a&itok=G83yO0z_) Science News ### [ New Study Examines Impulse Control, REM Sleep and Dopamine ](/blog/science-news/impulse-control) READ NOW ![Asian couple being supportive](/sites/default/files/styles/500x360/public/images/mentalhealthtips-conditionmoodsleep-blog.png?h=f0ffb5c0&itok=GxNXmMGr) Tips for Daily Living ### [ Mental Health Tips for Cognition, Mood and Sleep ](/blog/tips/mental-health-tips) READ NOW ### Suicide Prevention Resources These resources are free, confidential and are available 24/7: National Suicide Prevention Lifeline 1-800-273-8255 Now: 988 Suicide & Crisis Lifeline, dial/text 988. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline 1-800-662-4357 Crisis Text Line Text HOME to 741741 [MENTAL HEALTH RESOURCES](/living-with-parkinsons/emotional-mental-health) - Share on Facebook - Share on X - Share on LinkedIn