Clinical aspects of impulsive-compulsive behaviors under dopaminergic treatment-A scoping review.

Abstract

ObjectiveDopaminergic medications are commonly prescribed for Parkinson's disease (PD), restless legs syndrome, pituitary and psychotic disorders. Accumulating evidence indicates that dopaminergic treatment triggers impulsive-compulsive behaviors (ICBs), yet systematic synthesis of clinical evidence remains limited.MethodThis scoping review summarizes original research directly clinically relevant to ICBs under dopaminergic treatment, selected through systematic searches of MEDLINE PubMed, Web of Science, Embase and PsycInfo.ResultsOf 349 included studies, most focused on PD, with limited evidence from other populations. Reported ICB prevalences ranged between 15 and 35%. ICBs were associated with impaired daily functioning, depression, anxiety and significant family and financial burden. Younger age, male sex and dopamine agonist treatment, especially with pramipexole and ropinirole, were ICB risk factors. Management mainly involved tapering or discontinuing dopamine agonist treatment.ConclusionICBs in PD patients are well characterized, but under-recognition in health care and limited treatment strategies persist. Iatrogenic ICBs in other patient populations remain poorly studied.