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Diagnosis and treatment of impulse control disorders in patients with movement disorders
Journal article   Open access   Peer reviewed

Diagnosis and treatment of impulse control disorders in patients with movement disorders

Tiago A Mestre, Antonio P Strafella, Teri Thomsen, Valerie Voon and Janis Miyasaki
Therapeutic advances in neurological disorders, Vol.6(3), pp.175-188
05/2013
DOI: 10.1177/1756285613476127
PMCID: PMC3625015
PMID: 23634190
url
https://doi.org/10.1177/1756285613476127View
Published (Version of record) Open Access

Abstract

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine.
neurobehavioural Reviews parkinsonism Impulse control disorders restless leg syndrome dopamine agonist Parkinson’s disease non-motor complication

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