Impulse control disorders and dopaminergic treatments in Parkinson's disease

A group of disorders sharing a failure to resist an impulse to perform a typically pleasurable activity that is finally harmful to the person or to others are known under the common denomination of impulse control disorders (ICDs). These behaviors, possibly previously neglected by lack of awareness, are increasingly reported among PD patients. Compelling evidence has stressed the relation between dopaminergic replacement and development of ICDs in PD, especially but not exclusively, with dopamine agonist therapy. Besides dopaminergic replacement, younger age, smoking habit, presence of familiar gambling problems and alcohol abuse can increase the risk. ICDs in PD may greatly affect patients and caregivers quality of life, stressing the importance of their screening. Management strategies include a careful use of dopaminergic therapy using the lowest effective doses.