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Parkinson’s medications can effectively control movement symptoms of the disease. But for a small percentage of people they can have a surprising side effect: they can lead a person to develop irresistible and destructive impulses related to gambling, hypersexuality, abuse of anti-Parkinson’s medications, shopping, eating, and other activities.
Dopamine is involved in the brain’s “reward circuit,” as well as in controlling movement, and some people may be particularly sensitive to this effect of their medications.
Impulsive behaviors usually run counter to what was true of a person’s personality before the onset of Parkinson's. Although they can develop at any stage of disease, these behaviors tend to affect people whose disease is more advanced, and who are taking high doses of anti-Parkinson’s medications.
Often, impulsive behaviors begin when a new medication is added to the anti-Parkinson’s regimen, or when a dopaminergic medication is increased. It is important that you tell your doctor about such behaviors, as they can be destructive to both you and your network of support.
If you or others around you are noticing such behaviors it is important that you tell your doctor as soon as possible. Some people with Parkinson’s who have discussed this problem in retrospect state they did not bring it up at the time often because they found it too embarrassing to discuss with their doctor, even in the private and confidential environment of the doctor’s office.
In the end, by not addressing the issue altogether a more negative and devastating result occurred for some. Consequences such as divorce, overwhelming and even catastrophic debt, sexually transmitted diseases, or other such unwanted effect. Sometimes this led to a more serious crisis that required a more dramatic intervention where the person with Parkinson's had even less control over what they hoped would be a private and easily reconciled matter.
The lessons taken from these very painful situations have been to discuss such concerns with your doctor early and consider including life partners, family and friends in the loop in case they spot something before you yourself are noticing a change. The end goal is to be on the ‘lookout’ for impulsive behaviors so to avoid the problems that they cause since they can be destructive to both you and your network of support.
The Ups and Downs of Dopamine: Impulse Control and Parkinson's
Category: Non-Motor Symptoms and Complications of Parkinson’s
Resource Type: Publications
Publication Date: 2011
Author: Daniel Weintraub, M.D.
Publisher: Parkinson's Disease Foundation
Toll Free: (800) 457-6676
Associated URL: www.pdf.org/en/factsheets
Address: 1359 Broadway, Suite 1509
City: New York Zip:10018
State: New York
This fact sheet offers information about the impulse-control disorders (ICDs) that can occur in people with Parkinson's disease. An overview of these disorders, which can include pathological gambling, shopping, eating and hypersexuality, are discussed and possible treatment options are outlined. Also offered in Spanish.