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Introduction to Parkinson disease (PD) and its complications

Parkinson disease (PD) is a common neurodegenerative disorder in older adults characterized by motor and nonmotor symptoms and complications. Impulse control disorders (ICDs), such as pathological gambling, compulsive shopping, compulsive sexual behavior (hypersexuality), and binge eating disorder,...

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Autor principal: Marvanova, Marketa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: College of Psychiatric & Neurologic Pharmacists 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007592/
https://www.ncbi.nlm.nih.gov/pubmed/29955475
http://dx.doi.org/10.9740/mhc.2016.09.229
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author Marvanova, Marketa
author_facet Marvanova, Marketa
author_sort Marvanova, Marketa
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description Parkinson disease (PD) is a common neurodegenerative disorder in older adults characterized by motor and nonmotor symptoms and complications. Impulse control disorders (ICDs), such as pathological gambling, compulsive shopping, compulsive sexual behavior (hypersexuality), and binge eating disorder, affect 13.6% of the PD population. Use of dopamine receptor agonists (DRAs) is considered a major risk factor for ICD development. Amantadine and a high dose of levodopa were linked to ICDs to a lesser extent than DRAs. Based on the severity of behavior(s), ICDs can negatively impact social, professional, and familial lives of patients and their families. Ideally, all PD patients taking DRAs, high doses of levodopa, and/or amantadine should be routinely asked about or monitored for ICDs during therapy initiation and continuation. Dose decrease or withdrawal of the offending agent, primarily DRAs, is usually the most effective first step in ICD management. Careful dose adjustment with close monitoring is warranted due to risk for worsening of motor symptoms or emergence of dopamine agonist withdrawal syndrome (DAWS). About 1/3 of PD patients with ICD who decrease or discontinue DRA experienced DAWS. The lowest dose of DRA will need to be continued to balance ICDs and DAWS as it is not alleviated by other dopaminergic or psychotropic medications. Other therapies with low empiric evidence, such as amantadine, naloxone, cognitive behavior therapy, deep brain stimulation, and psychopharmacotherapy showed mixed results for ICD management. It is crucial that clinicians are familiar with the psychiatric complications of PD, including ICDs, beyond mere recognition and management of motor symptoms.
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spelling pubmed-60075922018-06-28 Introduction to Parkinson disease (PD) and its complications Marvanova, Marketa Ment Health Clin Mental Health in Geriatric Populations Parkinson disease (PD) is a common neurodegenerative disorder in older adults characterized by motor and nonmotor symptoms and complications. Impulse control disorders (ICDs), such as pathological gambling, compulsive shopping, compulsive sexual behavior (hypersexuality), and binge eating disorder, affect 13.6% of the PD population. Use of dopamine receptor agonists (DRAs) is considered a major risk factor for ICD development. Amantadine and a high dose of levodopa were linked to ICDs to a lesser extent than DRAs. Based on the severity of behavior(s), ICDs can negatively impact social, professional, and familial lives of patients and their families. Ideally, all PD patients taking DRAs, high doses of levodopa, and/or amantadine should be routinely asked about or monitored for ICDs during therapy initiation and continuation. Dose decrease or withdrawal of the offending agent, primarily DRAs, is usually the most effective first step in ICD management. Careful dose adjustment with close monitoring is warranted due to risk for worsening of motor symptoms or emergence of dopamine agonist withdrawal syndrome (DAWS). About 1/3 of PD patients with ICD who decrease or discontinue DRA experienced DAWS. The lowest dose of DRA will need to be continued to balance ICDs and DAWS as it is not alleviated by other dopaminergic or psychotropic medications. Other therapies with low empiric evidence, such as amantadine, naloxone, cognitive behavior therapy, deep brain stimulation, and psychopharmacotherapy showed mixed results for ICD management. It is crucial that clinicians are familiar with the psychiatric complications of PD, including ICDs, beyond mere recognition and management of motor symptoms. College of Psychiatric & Neurologic Pharmacists 2016-08-31 /pmc/articles/PMC6007592/ /pubmed/29955475 http://dx.doi.org/10.9740/mhc.2016.09.229 Text en © 2016 CPNP. http://creativecommons.org/licenses/by-nc/3.0/ The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Mental Health in Geriatric Populations
Marvanova, Marketa
Introduction to Parkinson disease (PD) and its complications
title Introduction to Parkinson disease (PD) and its complications
title_full Introduction to Parkinson disease (PD) and its complications
title_fullStr Introduction to Parkinson disease (PD) and its complications
title_full_unstemmed Introduction to Parkinson disease (PD) and its complications
title_short Introduction to Parkinson disease (PD) and its complications
title_sort introduction to parkinson disease (pd) and its complications
topic Mental Health in Geriatric Populations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007592/
https://www.ncbi.nlm.nih.gov/pubmed/29955475
http://dx.doi.org/10.9740/mhc.2016.09.229
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