Journal
BEHAVIOURAL PHARMACOLOGY
Volume 20, Issue 5-6, Pages 363-379Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/FBP.0b013e32833109a0
Keywords
addiction; basal ganglia; dopamine D-3 receptor; dopamine dysregulation syndrome; dopamine receptor agonist; gambling; hypersexuality; levodopa; Parkinson's disease; sensitization
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Over the last decade, evidence has emerged linking disorders in the impulsive-compulsive spectrum in Parkinson's disease to dopamine receptor agonist treatment. These disorders include hypersexuality, gambling and, to a minor extent, compulsive shopping and eating, as well as dopamine dysregulation syndrome, characterized by an addictive pattern toward dopamine replacement therapy and stereotyped behaviors, such as punding. These syndromes, which have only recently been recognized and are still underdiagnosed, have deleterious social consequences that warrant interventions at the clinical level and promotion of research at the preclinical level. In this review, we first provide a summary of features of Parkinson's disease and current pharmacological therapies associated with the development of dopamine dysregulation syndrome and impulsive-compulsive disorders. We also examine the dopamine receptors and brain areas important in reward and compulsive behaviors. We then critically examine the neuroadaptations in dopaminergic circuitries and the literature concerning gambling, hypersexuality, and other addictive behaviors in parkinsonian patients. Finally, we focus on suggestions pointing to a role for dopamine D-3 receptors and sensitization phenomena as the main factors which may be the origin of these disorders. Behavioural Pharmacology 20:363-379 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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