Living with Parkinson’ s
Dr. Dolhun Talks PD
Photo by Chad Batka
Impulse Control Disorders
Rachel Dolhun, MD, is a movement disorder specialist, board-certified neurologist and vice president of medical communications at MJFF.
Impulse control disorders( ICDs) are behavioral changes that can occur in some people with Parkinson’ s disease.
They most often develop after a dopamine agonist is started or increased. They can take many forms, including pathological gambling, compulsive shopping or spending, or binge eating. Unusual patterns of sexual activity or interest also may arise. ICDs may be difficult to recognize because, in general, they are normal behaviors that are practiced in abnormal ways. They can be a minor nuisance or have unfortunate consequences, potentially affecting relationships, social lives and careers.
While estimates vary, it is believed that fewer than 10 percent of people with Parkinson’ s disease( PD) experience ICDs. But these disorders are likely underreported. Patients may not bring them up to their doctors for any number of reasons: embarrassment, lack of recognition of the problem, or the physician’ s failure to ask.
10 The Fox Focus
WHAT CAUSES IMPULSE CONTROL DISORDERS? Pleasure or similar rewards usually drive impulsive behavior. Dopamine, a brain signaling chemical, plays a role in this pathway. People with Parkinson’ s are familiar with dopamine; its loss leads to the motor symptoms of the disease. Altered dopamine levels due to PD and the medications used to treat it— specifically the dopamine agonists( e. g., pramipexole,