Punding in patients on dopamine agonists for restless leg syndrome

Evans, Andrew; Stegeman, James R

doi:10.1002/mds.22309

Cited by 25 publications

(16 citation statements)

References 9 publications

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“…37 In addition, a female alcoholic patient who developed punding (nail filing and house cleaning) after taking disulfiram has been reported. 38 Interestingly, disulfiram inhibits DA b-hydroxylase, and the resultant elevation of DA levels and receptor sensitivity can enhance the aversive properties of cocaine.…”

Section: Methods and Review Criteriamentioning

confidence: 99%

Insights into pathophysiology of punding reveal possible treatment strategies

Fasano

Petrović²

2010

Mol Psychiatry

111

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Punding is a stereotyped behavior characterized by an intense fascination with a complex, excessive, nongoal oriented, repetitive activity. Men tend to repetitively tinker with technical equipment such as radio sets, clocks, watches and car engines, the parts of which may be analyzed, arranged, sorted and cataloged but rarely put back together. Women, in contrast, incessantly sort through their handbags, tidy continuously, brush their hair or polish their nails. Punders are normally aware of the inapposite and obtuse nature of the behavior; however, despite the consequent self-injury, they do not stop such behavior. The most common causes of punding are dopaminergic replacement therapy in patients affected by Parkinson's disease (PD) and cocaine and amphetamine use in addicts. The vast majority of information about punding comes from PD cases. A critical review of these cases shows that almost all afflicted patients (90%) were on treatment with drugs acting mainly on dopamine receptors D1 and D2, whereas only three cases were reported in association with selective D2 and D3 agonists. Epidemiological considerations and available data from animal models suggest that punding, drug-induced stereotypies, addiction and dyskinesias all share a common pathophysiological process. Punding may be related to plastic changes in the ventral and dorsal striatal structures, including the nucleus accumbens, and linked to psychomotor stimulation and reward mechanisms. Possible management guidelines are proposed.

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Section: Methods and Review Criteriamentioning

confidence: 99%

Insights into pathophysiology of punding reveal possible treatment strategies

Fasano

Petrović²

2010

Mol Psychiatry

111

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“…In PD, striatal and limbic dysregulation have been suggested as putative factors in compulsive behaviours arising from dopamine agonists [64]. Recently, behavioural complications, such as pathological gambling and punding, have been reported also in some RLS cases under dopaminergic treatment [65][66][67][68].…”

Section: Dopaminergic Agonistsmentioning

confidence: 99%

Treatment options for restless legs syndrome

Ferini‐Strambi

2009

Expert Opinion on Pharmacotherapy

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Background: Restless legs syndrome (RLS) is a common condition characterized by dysesthesia and an urge to move. Predominantly, symptoms occur at rest in the evening or at night, and they are alleviated by moving the affected extremity or by walking. Although the etiopathogenesis of RLS is still unknown, the rapid and dramatic improvement of RLS with dopaminergic agents suggests that dopaminergic system dysfunction may be a basic mechanism. Dopaminergic agents are the best-studied agents, and are considered first-line treatment of RLS. Objective: To review all options for the treatment of RLS, including the non-pharmacological ones. Methods: The treatment suggestions are based on evidence from studies published in peer-reviewed journals, or upon a comprehensive review of the medical literature. Results/conclusion: Extensive data are available for levodopa and dopamine agonists, especially for pramipexole and ropinirole. Pharmacological treatment should be limited to those patients who suffer from clinically relevant RLS with impaired sleep quality or quality of life. A treatment on demand is a clinical need in RLS cases that present intermittent symptoms.

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“…13,14 The latter are seen typically with levodopa therapy, although punding has been reported with DAA use. 15 The broad categories of hypersexuality, eating, shopping, and gambling, are still seen as the major clinical problems faced by patients, but additional compulsive activities, such as compulsive hobby participation extend the observation in certain patients, participation in rewarding activities can become excessive. 16 In order to emphasize the growing clinical and scientific interest in these behaviors, we performed an Ovid MEDLINE search with terms 'Parkinson's Disease, Compulsive Behavior, Addictive Behavior, Impulse Control…”

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confidence: 99%

Dopamine Agonists and Impulse Control Disorders in Parkinson’s Disease

Claassen¹,

Kanoff²,

Wylie³

2013

US Neurology

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The widespread clinical use of dopamine agonists (DAAs) was influenced largely by clinical trials comparing levodopa to DAAs (Ropinirole and Pramipexole) for the treatment of early Parkinson's disease (PD). Parkinson's Disease Impulse Control DisordersThe earliest reports of DAA-induced behavioral changes were about the same time as the completion of the DAA versus levodopa trials. Dopamine Agonists and Impulse Control Disorders in Parkinson's Disease AbstractThe emergence of the behavioral syndrome known as impulse control disorder (ICD) in Parkinson's disease (PD) has increasingly been associated with dopamine agonist (DAA) use. Clinical reports emphasize the presence of excessive, disruptive, and 'atypical' behaviors in PD patients that resolve after discontinuation or reductions of DAA therapy. The severity of these behaviors has resulted in a heightened clinical vigilance, especially in patients prescribed DAA. This review will discuss the historical rationale for the clinical use of DAA in PD, highlighting the increased association of ICD in patients prescribed DAA therapy. The association between DAA and the emergence of ICD supports the hypothesis that altered mesocorticolimbic function, further emphasized in behavioral and imaging studies, may account for the distinct compulsive hedonic behaviors that characterize the clinical features of this disorder. While the first-line treatment option is reduction and discontinuation of DAA therapy, other therapeutic options are discussed.

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Punding in patients on dopamine agonists for restless leg syndrome

Cited by 25 publications

References 9 publications

Insights into pathophysiology of punding reveal possible treatment strategies

Insights into pathophysiology of punding reveal possible treatment strategies

Treatment options for restless legs syndrome

Dopamine Agonists and Impulse Control Disorders in Parkinson’s Disease

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