Management of impulse control disorders in Parkinson's disease

Zhang, Susan; Dissanayaka, N.; Dawson, Andrew; O’Sullivan, John D.; Mosley, Philip; Hall, Wayne; Carter, Adrian

doi:10.1017/s104161021600096x

Cited by 15 publications

(16 citation statements)

References 83 publications

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“…Preserved cognitive functioning in patients with ICBs is also of clinical importance, especially for potential development of new management strategies for ICBs in PD. The current management strategy for ICBs is alterations of DRT, an approach not viable in all cases [36]. Alternative treatments have been suggested, including cognitive behavioral therapy [21,22], a psychotherapeutic treatment commonly used in the treatment of ICBs in the general population [13,25].…”

Section: Discussionmentioning

confidence: 99%

Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

et al. 2019

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The longitudinal course of ICBs in patients with Parkinson's disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson's disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive-Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1-5.6; p = 0.022) and 5.1 (95% CI 2.4-11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91-0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56-10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

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Section: Discussionmentioning

confidence: 99%

Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

et al. 2019

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“…However, most current evidence for psychotherapeutic treatments stems from isolated case reports where ICDs resolved after patients attended counselling therapy or various support groups. 3,4,5 In our search we found one systematic review on the use of CBT in movement disorders. There were two institutional publications; one providing an update on treatment for non-motor symptoms of PD and the other assessing the screening instruments available to assess ICDs.…”

Section: Methodsmentioning

confidence: 99%

“…This causes disruption in the social networks of patients and the loss of much-needed psychosocial stability. Having a stable social environment may additionally positively influence treatment outcomes with psychological therapy 5 and this therapeutic option will be of particular focus in our article. Coming to terms with the nature of the PD illness and managing the impairing symptoms is already destabilising for patients and carers.…”

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confidence: 99%

Management of impulse control disorders in Parkinson's disease

Yahya¹,

Khawaja

Chukwuma

2020

Prog Neurol Psychiatry

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“…76 Although a large number of case reports and small retrospective studies have described the benefits of treatment with selective serotonin receptor inhibitors or antipsychotics, the only reliable treatment is reduction of the dopamine agonist. 77 There is a threshold for some patients at which the behavior improves or resolves, but many require complete withdrawal. It is unknown if other agonists can then be introduced.…”

Section: Impulse Control Disordersmentioning

confidence: 99%

Nonmotor Symptoms in Parkinson's Disease

2017

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Nonmotor symptoms (NMSs) in Parkinson's disease (PD) have become increasingly recognized as major determinants of quality of life across cultures worldwide. Behavioral symptoms include dementia, depression, anxiety, apathy, and fatigue. Somatic symptoms include hypotension, constipation, diaphoresis, and pain. However, somatic symptoms may also be intrinsic, such as dementia, and iatrogenic, such as compulsive disorders. The authors address some of the more common disorders, yet few have been the target of clinical trials.

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Management of impulse control disorders in Parkinson's disease

Abstract: Further research will allow for the development of evidence-based guidelines for the management of ICDs in PD.

Cited by 15 publications

References 83 publications

Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

Management of impulse control disorders in Parkinson's disease

Nonmotor Symptoms in Parkinson's Disease

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