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Post of the Week: Impulsive and Compulsive Behaviors in PD


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#1 Dr. Fernandez

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Posted 27 February 2010 - 11:07 AM

How are impulse control and compulsive disorders treated?

Examples of impulse control disorders seen in Parkinson’s diasease include pathological gambling, hypersexuality, compulsive shopping, excessive spending, and binge eating. Examples of compulsive behaviors include compulsive dopaminergic medication use and “punding”--a stereotyped motor behavior in which there is an intense fascination with repetitive handling and examining of mechanical objects, such as taking apart and reassembling appliances or sorting common objects, like pebbles and jewelry.

The management of these behaviors typically includes decreasing or discontinuing dopamine agonist therapy (for impulse control disorders), lowering the overall dosage of Parkinson’s disease medications, or the addition of an atypical antipsychotic drug (for compulsive behavior). However, there have been a few reports of worsening of punding with quetiapine use (Miwa et al 2004). Occasionally, clomipramine and other SSRI’s may alleviate punding. Referrals for specific treatments (e.g. gambling treatment) or the use of behavioral interventions may also be helpful and should not be overlooked.
Hubert H. Fernandez

#2 Cherie

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Posted 27 April 2010 - 09:34 AM

My husband has young on set Parkinson's and developed impulse control disorder and he did some things that are totally out of character for him. I really need to understand what hapened. Answering the following questions would help me a lots. When a person is under the influence of impulse control disorder do they fully realize what they are doing and do they have total recollection of their actions or is it some vague memory?
Cherie

#3 Dr. Okun

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Posted 06 June 2010 - 12:05 PM

In general the patients suffering from this problem lack insight and may have fuzzy or inaccurate memory. When treated they usually do well and are very apologetic. We have seen many people almost lose or lose marriages over this issue. In most cases it is out of the control of the offending spouse and a lot of understanding is needed (although because the offending action can be so bad, it is sometimes difficult for a spouse). We use counseling psychology, social work, and marriage counselors.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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