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Management of impulse control disorders in Parkinson's disease

Published online by Cambridge University Press:  04 July 2016

Susan Zhang ,
Nadeeka N. Dissanayaka ,
Andrew Dawson Open the ORCID record for Andrew Dawson [Opens in a new window] ,
John D. O'Sullivan ,
Philip Mosley ,
Wayne Hall  and
Adrian Carter
Susan Zhang
Affiliation:
UQ Centre for Clinical Research, The University of Queensland, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia
Nadeeka N. Dissanayaka
Affiliation:
UQ Centre for Clinical Research, The University of Queensland, Queensland, Australia The Neurology Research Centre, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia School of Psychology, The University of Queensland, Queensland, Australia
Andrew Dawson
Affiliation:
School of Psychological Sciences, Monash University, Victoria, Australia
John D. O'Sullivan
Affiliation:
The Neurology Research Centre, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia
Philip Mosley
Affiliation:
School of Medicine, The University of Queensland, Herston, Queensland, Australia Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, St Lucia, Queensland, Australia Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
Wayne Hall
Affiliation:
Centre for Youth Substance Abuse Research, The University of Queensland, Queensland, Australia
Adrian Carter*
Affiliation:
UQ Centre for Clinical Research, The University of Queensland, Queensland, Australia School of Psychological Sciences, Monash University, Victoria, Australia
*
Correspondence should be addressed to: Adrian Carter, Senior Research Fellow, Brain & Mental Health Laboratory, School of Psychological Sciences, Monash University, 770 Blackburn Rd, Monash University, Clayton VIC 3800, Australia. Phone: +61 3 9902 9431. Email: adrian.carter@monash.edu.
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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.

Keywords

Parkinson's diseaseimpulse control disorderspsychopharmacologydeep brain stimulationcognitive behavioral therapy
Type
Review Article
Information
International Psychogeriatrics , Volume 28 , Issue 10 , October 2016 , pp. 1597 - 1614
Copyright
Copyright © International Psychogeriatric Association 2016 

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