Impulse-control disorders (ICDs) such as compulsive gambling, buying, sexual, and eating behaviours, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness.
Related behaviours include punding (stereotyped, repetitive, purposeless behaviours), dopamine dysregulation syndrome (DDS), levodopa misuse (compulsive medication overuse), hobbyism (e.g. - compulsive internet use, artistic endeavours, and writing), and hypersexuality or paraphilias.
These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity.
Patients often do not report these behaviours due to shame or guilt, and so it is important to ask these questions directly!
Management includes decreasing the dose of the offending agent (usually a dopamine agonist) or completely stopping it.