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The Effect of Dopaminergic Medication on Impulse Control and Compulsive Behaviour: A Translational Perspective
Mirjam Wolfschlag1,2, Elena Espa3, Kevin Oliveira Hauer4,5
1Clinical Addiction Research Unit, Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.
Basic & Clinical Pharmacology & Toxicology
|June 15, 2026
Summary
Dopamine medications for Parkinson's disease can cause impulsive-compulsive behaviors (ICB). Research suggests high D2/3-selectivity agonists are linked to ICB, with dose-dependency noted.
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Medicine
Background:
- Dopaminergic medications for Parkinson's disease (PD) and restless legs syndrome can induce impulsive-compulsive behaviors (ICB).
- ICB significantly impairs patients' quality of life.
Purpose of the Study:
- To review translational evidence on iatrogenic ICB.
- To synthesize findings from epidemiological, clinical, neuroimaging, and preclinical studies.
Main Methods:
- Narrative review of existing literature.
- Analysis of epidemiological, clinical, neuroimaging, and preclinical studies.
- Examination of intervention studies.
Main Results:
- Dopamine agonists with high D2/3-selectivity are strongly associated with ICB.
- ICB is often dose-dependent, but effects of drug combinations and extended-release formulations are less clear.
- Tapering or replacing dopamine agonists can reduce ICB; no specific pharmacotherapy for ICB is established.
Conclusions:
- Striatum and prefrontal cortex involvement in iatrogenic ICB is supported by human and animal studies.
- Integrated human and animal model research can inform the development of safer dopaminergic drugs and targeted impulsivity/compulsivity treatments.
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