Impulse control disorder and punding arising in a patient treated with levodopa

Introduction: Dopamine is not only involved in voluntary movement control but also plays a significant role in the brain's reward system and in the modulation of behaviour. Parkinson's disease is an archetypal disorder of dopamine function characterised by motor, cognitive, autonomic and behavioural symptoms. Dopamine replacement therapy has been implicated to cause compulsive behaviours, such as pathological gambling, compulsive eating, compulsive shopping and hypersexuality or repetitive complex stereotype and purposeless actions called punding. Dopamine agonists are still considered to be the most potent trig…