Sexual addiction and parkinson

Impulse control disorders (ICD) are frequent side effects of dopamine replacement therapy (DRT) used in Parkinson's disease (PD) with devastating consequences on the patients and caregivers. ICD are behavioural addictions including compulsive gambling, shopping, sexual behaviour, and binge eating that are mainly associated with dopamine D2/D3 agonists. Their management is a real clinical challenge due to the lack of therapeutic alternative. Clinical studies have identified demographic and clinical risk factors for ICD such as younger age at disease onset, male gender, prior history of depression or substance abuse, REM sleep behaviour disorders and higher rate of dyskinesia...

Dopaminergic medications used in the treatment of patients with Parkinson's disease are associated with motor and non-motor behavioural side-effects, such as dyskinesias and impulse control disorders also known as behavioural addictions. Levodopa-induced dyskinesias occur in up to 80% of patients with Parkinson's after a few years of chronic treatment. Impulse control disorders, including gambling disorder, binge eating disorder, compulsive sexual behaviour, and compulsive shopping occur in about 17% of patients with Parkinson's disease on dopamine agonists...

Neuropeptides are endogenous substances present in nerve cells and involved in nervous system functions. Neuropeptides are synthetized in large precursor proteins and several are formed in the same precursor. Neuropeptides affect learning and memory processes, social, sexual and maternal behavior, pain and addiction, body temperature, food and water intake e.a. In addition, neuropeptides possess trophic influences on the nervous system, neuroleptic-like andpsychostimulant-like activities. Disturbances in classical neurotransmitter activity as found in Parkinson's disease, psychoses, and dementia, may also be caused by disturbances in neuropeptide activity...

INTRODUCTION: Aripiprazole, an atypical or second-generation antipsychotic, is usually well tolerated. It is an approved treatment for schizophrenia and mania in bipolar disorder type 1. Unlike the other antipsychotics, it has high affinity agonist properties for dopamine D2 and D3 receptors. It has also 5-HT1A partial agonist and 5-HT2A antagonist properties. Aripiprazole is a first or second line treatment frequently used because it has reduced side effects such as weight gain, sleepiness, dyslipidemia, insulin resistance, hyperprolactinemia and extrapyramidal symptoms...

Parkinson's disease includes neuropsychiatric manifestations, such as depression, anxiety, apathy, psychosis, and impulse control disorders, which often are unreported by patients and caregivers or undetected by doctors. Given their substantial impact on patients and caregivers as well as the existence of effective therapies for some of these disorders, screening for neuropsychiatric symptoms is important. Instruments for screening have a particular methodology for validation, and their performance is expressed in terms of accuracy compared with formal diagnostic criteria...

OBJECTIVE: This review examines the evidence that deep brain stimulation (DBS) has extensive impact on nonmotor symptoms (NMSs) of patients with Parkinson's disease (PD). DATA SOURCES: We retrieved information from the PubMed database up to September, 2015, using various search terms and their combinations including PD, NMSs, DBS, globus pallidus internus (GPi), subthalamic nucleus (STN), and ventral intermediate thalamic nucleus. STUDY SELECTION: We included data from peer-reviewed journals on impacts of DBS on neuropsychological profiles, sensory function, autonomic symptoms, weight changes, and sleep disturbances...

Sleep disturbances are common in patients with Parkinson's disease (PD) and are even more prevalent in patients with behavioural addictions, such as pathological gambling, compulsive sexual behaviour, compulsive buying, binge eating, punding, and the compulsive use of dopamine replacement therapy. An overview of the relationship between these impulse control disorders and sleep disturbances is given and potential underlying mechanisms and treatment strategies are covered.

There is increasing awareness that the medications used to treat the motor symptoms of Parkinson's disease (PD) contribute to the development of behavioral addictions, which have been clinically defined as impulsive-compulsive behaviors (ICBs). These features include pathological gambling, compulsive sexual behavior, binge eating, compulsive shopping, excessive hobbyism or punding, and the excessive use of dopaminergic medication. ICBs frequently have devastating effects on the social and occupational function of the affected individuals as well as their families...

OBJECTIVE: The purpose of this study was to develop a short and reliable measure of hypersexuality that could be used in everyday practice in patients with Parkinson's disease (PD). DESIGN: The original questionnaire containing twenty-five-items, the Sexual Addiction Screening Test (SAST), was shortened and tested in a PD population. METHODS: Successive reductions were performed until a final set of items satisfied the model fit requirements...

Apomorphine (APO) is an aporphine derivative used in human and veterinary medicine. APO activates D₁, D(2S), D(2L), D₃, D₄, and D₅ receptors (and is thus classified as a non-selective dopamine agonist), serotonin receptors (5HT(1A), 5HT(2A), 5HT(2B), and 5HT(2C)), and α-adrenergic receptors (α(1B), α(1D), α(2A), α(2B), and α(2C)). In veterinary medicine, APO is used to induce vomiting in dogs, an important early treatment for some common orally ingested poisons (e.g., anti-freeze or insecticides)...

Impulsive-compulsive behaviours (ICBs) are an increasingly well-recognised adverse-effect of dopaminergic medications used to treat Parkinson's disease. ICBs include pathological gambling, compulsive sexual behaviour, compulsive buying, and binge eating, together with punding and the addiction-like compulsive use of dopamine replacement therapy, or dopamine dysregulation syndrome. The prevalence of ICBs was approximately 14% in a large study undertaken in specialist movement disorder clinics. Dopamine dysregulation syndrome is more associated with compulsive l-dopa use, whereas other ICBs are more linked with oral dopamine agonist use...

BACKGROUND: Substance and behavioral addictions have already been described separately or in combination in Parkinson's disease. However, no comparisons of the prevalence of addictive behaviors in patients with Parkinson's disease and the general population have been published. The objective of this study was to compare the prevalence and characteristics of addictions (gambling, hypersexuality, tobacco, and alcohol) in patients with Parkinson's disease and in a matched, paired sample from the general population...

AIMS: To describe the prevalence, phenomenology and correlates of 'impulse control disorders' (ICDs) in patients with Parkinson's disease (PD) treated with dopamine replacement therapy (DRT); to assess the strength of the evidence that DRT plays a contributory causal role in these disorders; and to highlight the implications of these disorders for research in the addiction field. METHODS: PubMed and Web of Science databases were searched and the reference lists of papers examined...

BACKGROUND: Dopamine agonists (DAs), long used in treating Parkinson's disease and effective in relieving symptoms of restless legs syndrome, have frequently been reported to induce problematic compulsive behaviors (e.g., obsessive gambling, hypersexuality) in individuals who had never had difficulties with such behaviors before. OBJECTIVE: The authors report two cases that add to a small-but-growing literature suggesting that these drugs be dispensed with appropriate caution...

INTRODUCTION: Prevalence of psychiatric disorders in patients suffering from Parkinson's disease varies from 12 to 90%. The most common disorder in the natural evolution of Parkinson's disease is depression. However, episodes of psychosis and hypomania are related to treatment with L-dopa and dopaminergic agents. Other recognized, although less frequent, psychiatric disorders are hypersexuality and development of certain addictive behaviors, which is compulsive gambling and overdosing of anti-Parkinson agents...

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Parkinson's disease is primarily considered a motor disease characterized by rest tremor, rigidity, bradykinesia and postural disturbances. However, neuropsychiatric complications, including mood and anxiety disorders, fatigue, apathy, psychosis, cognitive impairment, dementia, sleep disorders and addictions, frequently complicate the course of the illness. The pathophysiologic features of these complications are multifaceted and include neuropathophysiologic changes of a degenerative disease, exposure to antiparkinsonian treatments and emotional reactions to having a disabling chronic illness...

AIM: To report the case of a patient, who in the context of an anti-Parkinsonian therapy, developed addiction to apomorphine. METHODS: Clinical case description. RESULTS: Apomorphine is a dopaminergic agonist that acts directly on D2 receptors. It has been used in alcoholism, male sexual dysfunction and with diagnostic and therapeutic purposes in Parkinson's disease (PD). CONCLUSIONS: The present work describes the case of a woman with PD who developed a loss of control over the consumption of apomorphine that resulted in a significant impairment of her functioning...

Apathy and fatigue, sexual disturbances, mania, sleep disturbances, personality changes, pathologic gambling, and addiction to antiparkinson agents occur in patients with PD and may pose considerable stress on the patients themselves and their caregivers. With the exception of apathy and fatigue, little is known regarding the prevalence of these symptoms in patients with PD. The pathophysiologic mechanisms are unknown, although disturbances of the mesolimbic and mesocortical dopaminergic pathways are probably involved...

Pathological hypersexuality developed in 13 patients with PD and two patients ultimately diagnosed clinically with MSA. Hypersexuality began within 8 months after starting dopamine agonist therapy in 14 of 15 cases, including four on agonist monotherapy. It resolved in the four cases where the agonist was stopped, despite continued levodopa therapy. This was not an isolated behavioral problem in most, with additional compulsive or addictive behaviors coinciding in nine patients (60%). A systematic literature review of pathological hypersexuality in PD revealed similar medication histories; combining these cases with our series, 26 of 29 patients (90%) were on adjuvant dopamine agonists...