Management of impulse control disorders in Parkinson's disease

Zhang, Susan, Dissanayaka, Nadeeka N., Dawson, Andrew, O’Sullivan, John D., Mosley, Philip, Hall, Wayne and Carter, Adrian (2016) Management of impulse control disorders in Parkinson's disease. International Psychogeriatrics, . doi:10.1017/S104161021600096X

Author Zhang, Susan
Dissanayaka, Nadeeka N.
Dawson, Andrew
O’Sullivan, John D.
Mosley, Philip
Hall, Wayne
Carter, Adrian
Title Management of impulse control disorders in Parkinson's disease
Journal name International Psychogeriatrics   Check publisher's open access policy
ISSN 1041-6102
Publication date 2016-07-04
Year available 2016
Sub-type Article (original research)
DOI 10.1017/S104161021600096X
Open Access Status Not Open Access
Total pages 18
Place of publication Cambridge, United Kingdom
Publisher Cambridge University Press
Collection year 2017
Language eng
Formatted abstract
Background: Impulse control disorders (ICDs) have become a widely recognized non-motor complication of Parkinson's disease (PD) in patients taking dopamine replacement therapy (DRT). There are no current evidence-based recommendations for their treatment, other than reducing their dopaminergic medication.

Methods: This study reviews the current literature of the treatment of ICDs including pharmacological treatments, deep brain stimulation, and psychotherapeutic interventions.

Results: Dopamine agonist withdrawal is the most common and effective treatment, but may lead to an aversive withdrawal syndrome or motor symptom degeneration in some individuals. There is insufficient evidence for all other pharmacological treatments in treating ICDs in PD, including amantadine, serotonin selective reuptake inhibitors, antipsychotics, anticonvulsants, and opioid antagonists (e.g. naltrexone). Large randomized control trials need to be performed before these drugs can be routinely used for the treatment of ICDs in PD. Deep brain stimulation remains equivocal because ICD symptoms resolve in some patients after surgery but may appear de novo in others. Cognitive behavioral therapy has been shown to improve ICD symptoms in the only published study, although further research is urgently needed.

Conclusions: Further research will allow for the development of evidence-based guidelines for the management of ICDs in PD.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Created: Mon, 18 Jul 2016, 17:39:40 EST by Ms Kate Rowe on behalf of Learning and Research Services (UQ Library)