Joutsa Juho, Kaasinen Valtteri
Satakunnan keskussairaala, neurologian klinikka, TYKS.
TYKS ja Turun yliopisto, valtakunnallinen PET-keskus.
Duodecim. 2013;129(22):2351-8.
Of the patients having Parkinson's disease, up to third encounters some degree of impulse control problems and one out of seven suffers from true impulse control disorders such as pathological gambling, hypersexuality, compulsive shopping and binge eating. Dopaminergic drugs used in anti-Parkinson therapy, especially dopamine agonists, increase the risk of these disorders. Impulse control disorders are associated with a relatively more active dopamine-mediated neurotransmission of the mesolimbic and mesocortical system. Discontinuation of dopamine agonist medication can thus be considered as the first line treatment of these disorders.
在患有帕金森病的患者中,高达三分之一会出现某种程度的冲动控制问题,七分之一的患者患有真正的冲动控制障碍,如病理性赌博、性欲亢进、强迫性购物和暴饮暴食。抗帕金森治疗中使用的多巴胺能药物,尤其是多巴胺激动剂,会增加这些障碍的风险。冲动控制障碍与中脑边缘系统和中脑皮质系统中相对更活跃的多巴胺介导的神经传递有关。因此,停用多巴胺激动剂药物可被视为这些障碍的一线治疗方法。