Liang John, Groves Mark, Shanker Vicki L
Icahn School of Medicine at Mount Sinai Mount Sinai Beth Israel New York New York USA.
Mov Disord Clin Pract. 2015 Jun 4;2(3):283-285. doi: 10.1002/mdc3.12167. eCollection 2015 Sep.
Impulse control disorders (ICDs) are nonmotor complications of dopaminergic medications characterized by problems in behavioral self-control. Common management involves discontinuing or lowering dopaminergic medication, often producing motor worsening. We performed a retrospective chart review of Parkinson's disease (PD) patients treated with clozapine for ICDs. Four patients treated with clozapine for ICD were identified. Three patients were men. All 4 took dopaminergic medications at the time that ICDs developed; all received dopamine agonist therapy. ICDs included compulsive shopping, binge drinking, and hypersexuality. All 4 patients had complete resolution of symptoms while taking clozapine (12.5-37.5 mg). Two patients discontinued clozapine because of side effects. Larger studies are needed to further evaluate clozapine's role in treating PD patients with ICD.
冲动控制障碍（ICDs）是多巴胺能药物的非运动并发症，其特征为行为自我控制方面存在问题。常见的处理方法包括停用或减少多巴胺能药物，这往往会导致运动症状恶化。我们对接受氯氮平治疗冲动控制障碍的帕金森病（PD）患者进行了一项回顾性病历审查。确定了4例接受氯氮平治疗冲动控制障碍的患者。3例为男性。在冲动控制障碍出现时，所有4例患者都在服用多巴胺能药物；均接受了多巴胺激动剂治疗。冲动控制障碍包括强迫购物、暴饮和性欲亢进。所有4例患者在服用氯氮平（12.5 - 37.5毫克）期间症状均完全缓解。2例患者因副作用停用了氯氮平。需要开展更大规模的研究以进一步评估氯氮平在治疗患有冲动控制障碍的帕金森病患者中的作用。
