Objective: In recent years there are an increasing number of impulse control disorders (ICDs), such as pathologic gambling, hypersexuality, compulsive shopping, compulsive eating, punding and compulsive medication use related to aberrant or excessive dopamine agonist treatment of Parkinson’s disease (PD).

Background: Here we report the case of ICDs become apparent from rasagiline treatment in PD patient.

Methods: Our case is a 43 year old man with a ten year history of idiopathic PD. He worked Computer Company as an operator and he was married. He was taking piribedil retard tablet 50 mg three times. With the initiation of a rasagiline (MAO-B inhibitor) some 4 years ago, impulsive behaviors began to arise of which hypersexuality has been the most problematic. He occurred an extremely desire for sex. His wife has become complained that he was obsessed with daily sexual coupling and she came to the divorce process. According to his wife’s testimony that doing too much unnecessary shopping, excessive credit card use, the opportunity was spending a lot of time on the internet. It was difficult to adapt to patients in terms of treatment and follow-up it lasted irregularly.

Results: It is uncommonly reported hypersexuality that known is side effects of anti-Parkinson medications. Rasagiline blocking MAO-B enzyme allows the increase of dopamine in the synaptic gap. With the increased dopaminergic stimulation occurs dysfunction in neuroanatomical circuit containing on ventral tegmental area and related frontostriatal region. Including dopaminergic stimulation presumed abnormal or exaggerated behavior associated cluster, impulse control disorders is increasingly being defined by the day. Inability to resist the fascination which will be harmful to the basic features of an action or impulse him or others are described as a group of diseases in DSM-IV.

Conclusions: A resting tremor of present unlike sex, gambling and shopping is an activity common in everyday life. So problematic behavior is seen as a deviation from normal and can occur in the form of characters. ICDS is known that more young-onset patients seen. The prevalence of ICDs in PD has been reported to be approximately 6.6%. The treatment of ICDs patients is difficult, and response to treatment is limited. During the examination of patients and their families should be informed about these issues. Especially before the onset of the PD in patients with early-onset, family member with alcohol abuse disorders and impulse control is important in identifying patients at risk group of patients. This disease is a clear condition requiring cooperation between psychiatrists and neurologists for optimal care and research.

References: 1. Voon V, Hassan K, Zurowski M, et al. Prevalence of repetitive and reward seeking behaviors in Parkinson disease. Neurology. 2006;67(7):1254-7. 2. Perez-Lloret S, Rey MV, Fabre N, et al. Prevalence and pharmacological factors associated with impulse-control disorder symptoms in patients with Parkinson disease. Clin Neuropharmacol. 2012;35(6):261-5.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/rasagiline-as-adjunctive-therapy-induced-impulse-control-disorders-in-parkinsons-disease/