First trial on management of ICD in Parkinson disease and new risk factors

Impulse control disorders (ICD) are one of the main concerns when dealing with Parkinson’s disease (PD) treatment. Many movement disorder specialists have witnessed dramatic histories of ruin, relationship problems, litigation and, more commonly, distress and grief of patients with PD and caregivers. The frequency of ICD in PD is highly variable (15%–40%) depending on certain features of the population, particularly younger age and male sex.1 2 Dopamine agonists, mainly D3 agonists (pramipexole, ropinirole and rotigotine), are the main risk factor. This is not a dose-dependent effect; however, higher doses entail a greater risk. Dopamine agonists with a short half-life may also carry a higher risk, as rotigotine patch and prolonged …