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Punding on L-dopa.

H H Fernandez¹, J H Friedman

¹Department of Neurology, Brown University School of Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860, USA.

Movement Disorders : Official Journal of the Movement Disorder Society

|September 24, 1999

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Punding, a repetitive behavior, is linked to Parkinson's disease (PD) medications. Reducing dopaminergic drugs like L-dopa improved symptoms in three PD patients experiencing punding.

Area of Science:

Neurology
Pharmacology

Background:

Punding is a stereotypic motor behavior involving repetitive handling and examination of objects.
It is hypothesized to be dopamine-related, with limited prior reports in Parkinson's disease (PD) patients using L-dopa.

Observation:

Three cases of punding in postmenopausal women (aged 65-72) with PD (10-20 years duration) on high-dose L-dopa (500-1900 mg/day) are presented.
Observed behaviors included fascination with cans, compulsive cataloging of jewelry, carpet thread picking, excessive gardening, and disassembling/reassembling flashlights.

Findings:

All three patients exhibited significant improvement in punding behaviors following a reduction in their anti-Parkinsonian (PD) medication dosage.
This suggests a direct link between dopaminergic medication and the manifestation of punding.

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Implications:

Punding may be an underrecognized complication of dopaminergic therapy in Parkinson's disease.
Clinicians should consider medication adjustments when patients present with such repetitive, object-focused behaviors.