The Effect of Dopaminergic Medication on Impulse Control and Compulsive Behaviour : A Translational Perspective
(2026) In Basic and Clinical Pharmacology and Toxicology 139(1).- Abstract
Dopaminergic medication used in disorders like Parkinson's disease (PD) and restless legs syndrome can cause impulsive-compulsive behaviour (ICB), often with strong negative effects on patients' quality of life. This narrative review presents translational evidence on iatrogenic ICB, taking findings from epidemiological, clinical, neuroimaging and preclinical studies into consideration. Epidemiological and clinical studies find dopamine agonists with high D2/3-selectivity to be most strongly linked to ICB. Their effect on ICB has often been shown to be dose-dependent, but the impact of combining different dopaminergic drugs or applying extended-release formulations is less clear. Intervention studies support tapering or replacing... (More)
Dopaminergic medication used in disorders like Parkinson's disease (PD) and restless legs syndrome can cause impulsive-compulsive behaviour (ICB), often with strong negative effects on patients' quality of life. This narrative review presents translational evidence on iatrogenic ICB, taking findings from epidemiological, clinical, neuroimaging and preclinical studies into consideration. Epidemiological and clinical studies find dopamine agonists with high D2/3-selectivity to be most strongly linked to ICB. Their effect on ICB has often been shown to be dose-dependent, but the impact of combining different dopaminergic drugs or applying extended-release formulations is less clear. Intervention studies support tapering or replacing dopamine agonists for ICB reduction, whereas no efficacious pharmacotherapy has been identified for ICB treatment specifically. Adequate animal models for mimicking different types of ICB are available, and point, in line with human neuroimaging studies, towards an involvement of striatum and prefrontal cortex in iatrogenic ICB. Overall, complementary research designs have led to profound evidence regarding the occurrence of ICB in PD and establishing methods transferable to other, less-studied patient populations. A combined approach integrating insights from human studies and animal models could contribute to developing dopaminergic drugs with lower ICB risk but also specific pharmacotherapies for impulsivity or compulsivity in the future.
(Less)
- author
- Wolfschlag, Mirjam
LU
; Espa, Elena
LU
; Hauer, Kevin Oliveira
LU
; Timpka, Jonathan
LU
; Smith, Ruben
LU
; Odin, Per
LU
; Cenci, Maria Angela
LU
and Håkansson, Anders
LU
- organization
-
- Clinical addiction research unit (research group)
- Psychiatry (Lund)
- Basal Ganglia Pathophysiology (research group)
- MultiPark: Multidisciplinary research on neurodegenerative diseases
- Neurology, Lund
- Clinical Memory Research (research group)
- Restorative Parkinson Unit (research group)
- LU Profile Area: Proactive Ageing
- Regeneration in Movement Disorders (research group)
- eSSENCE: The e-Science Collaboration
- LU Profile Area: Natural and Artificial Cognition
- publishing date
- 2026-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- dopamine agonist, impulse control disorder, impulsive-compulsive behaviour, Parkinson's disease, restless legs syndrome
- in
- Basic and Clinical Pharmacology and Toxicology
- volume
- 139
- issue
- 1
- article number
- e70264
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:42289917
- scopus:105041910195
- ISSN
- 1742-7835
- DOI
- 10.1111/bcpt.70264
- language
- English
- LU publication?
- yes
- id
- 7f516472-e212-4f59-924d-c08f1e7dd533
- date added to LUP
- 2026-07-03 14:33:43
- date last changed
- 2026-07-03 14:34:51
@article{7f516472-e212-4f59-924d-c08f1e7dd533,
abstract = {{<p>Dopaminergic medication used in disorders like Parkinson's disease (PD) and restless legs syndrome can cause impulsive-compulsive behaviour (ICB), often with strong negative effects on patients' quality of life. This narrative review presents translational evidence on iatrogenic ICB, taking findings from epidemiological, clinical, neuroimaging and preclinical studies into consideration. Epidemiological and clinical studies find dopamine agonists with high D2/3-selectivity to be most strongly linked to ICB. Their effect on ICB has often been shown to be dose-dependent, but the impact of combining different dopaminergic drugs or applying extended-release formulations is less clear. Intervention studies support tapering or replacing dopamine agonists for ICB reduction, whereas no efficacious pharmacotherapy has been identified for ICB treatment specifically. Adequate animal models for mimicking different types of ICB are available, and point, in line with human neuroimaging studies, towards an involvement of striatum and prefrontal cortex in iatrogenic ICB. Overall, complementary research designs have led to profound evidence regarding the occurrence of ICB in PD and establishing methods transferable to other, less-studied patient populations. A combined approach integrating insights from human studies and animal models could contribute to developing dopaminergic drugs with lower ICB risk but also specific pharmacotherapies for impulsivity or compulsivity in the future.</p>}},
author = {{Wolfschlag, Mirjam and Espa, Elena and Hauer, Kevin Oliveira and Timpka, Jonathan and Smith, Ruben and Odin, Per and Cenci, Maria Angela and Håkansson, Anders}},
issn = {{1742-7835}},
keywords = {{dopamine agonist; impulse control disorder; impulsive-compulsive behaviour; Parkinson's disease; restless legs syndrome}},
language = {{eng}},
number = {{1}},
publisher = {{Wiley-Blackwell}},
series = {{Basic and Clinical Pharmacology and Toxicology}},
title = {{The Effect of Dopaminergic Medication on Impulse Control and Compulsive Behaviour : A Translational Perspective}},
url = {{http://dx.doi.org/10.1111/bcpt.70264}},
doi = {{10.1111/bcpt.70264}},
volume = {{139}},
year = {{2026}},
}