Compulsive Behavior in Parkinson’s Disease

Compulsive behavior, though not common, sometimes occurs in patients with Parkinson’s disease and is more likely to be associated with those on treatment with dopamine agonists, although other types of anti-Parkinson drugs may be implicated too. These impulse-control disorders are seen more often in men than in women and are more common in patients with young-onset Parkinson’s disease and may be accompanied by psychotic symptoms such as hallucinations and delusions, or mood disorders such as depression or anxiety.

What is Compulsive Behavior?

Compulsive behavior is when a person is unable to control his impulse or desire, or resist a temptation, even though it ultimately harms him or others. This sort of behavior is motivated by the anticipation of intense pleasure and gratification is often seen to be out of character with his previous normal behavior.

Types of Compulsive Behavior in Parkinson’s Disease

  • Pathological gambling – recurrent, compulsive and addictive gambling habit which cannot be controlled in spite of its destructive effects and may include experience with casinos, lotteries, internet or television based games and raffles. He may deceive others or even resort to stealing to satisfy this intense urge for gambling, paying no heed to breakdown of relationships or even total bankruptcy. Pathological gamblers often suffer from mood swings, irritability and suicidal tendencies.
  • Hypersexuality – this may range from inappropriate sexual thoughts or urges to offensive sexual remarks or actions which are totally out of character with his usual behavior. There may be increasing demands for sexual activity or indiscriminate sexual activity, offensive sexual remarks in public, exhibitionism or cross-dressing. Additional accompanying features such as irritability, mood swing, anger or sleep disturbances may be present.
  • Compulsive eating – compulsive or binge eating may not be noticeable in the early stages of Parkinson’s disease and may be thought to be normal behavior.
  • Compulsive shopping
  • Compulsive hobbyism or punding
  • Drug abuse of anti-Parkinson’s medications – addiction to anti-Parkinson’s medications often leads to excessive and inappropriate intake of such medicines, tolerance and psychological dependence, and demand for increase in dopaminergic medication.

More than one compulsive behavior may be present in a patient with Parkinson’s disease and it may occur in

  • Advanced cases of Parkinson’s disease.
  • Patients on high dose of anti-Parkinson’s medications to control motor functions, especially dopamine agonists, but any anti-Parkinson’s medication may be involved.
  • After neurosurgical treatment such as deep brain stimulation.

Treatment of Compulsive Behavior in Parkinson’s Disease

  • Treatment is often difficult because the higher doses of anti-Parkinson’s medication needed to control motor symptoms may be the cause of the compulsive behavior.
  • Changing from dopamine agonists drugs to levodopa may help because, in some cases, levodopa is less likely to cause this sort of disruptive behavior than dopamine agonists.
  • Where compulsive behavior is initiated by an addition or increase in dose of dopaminergic medication, adjusting or reducing the dose or discontinuing the medicine altogether may help.
  • Using a different type of dopaminergic medicine may solve the problem.
  • Anti-psychotics and antidepressants help to control associated symptoms.
  • Control of opportunities to carry out disturbing behavior.
  • Psychiatric evaluation or psychiatric hospitalization.

24 Comments

  1. Hi.

    You state that compulsive behaviour in Parkinson’s sufferers is not common. In fact it has been shown to occur to at least 1 in 7 of patients who take dopamine agonists, and the real rate is likely to be even higher, as many of those afflicted by compulsiveness try desperately to hide their problem due to embarrassment.

    I myself was prescribed the agonist Cabergoline in 2000, and continued for 7 years, even though my neurologist knew of the risk by 2003, and of all the problems I was having behaviourally.

    He decided the drug was so good at improving my Parkinson’s symptoms (which it was) that it would be better to put up with the side effects.

    Unfortunately HE DIDN’T TELL ME, and I carried on getting worse and worse (compulsion-wise) until I discovered for myself on the ‘Net the link between compulsiveness and Cabergoline. I came off it, and returned to normality in a few days.

    During those 7 years, however, I had lost my job, house, cars, all my property and assets, family and friends. I wasted away around £140,000 on gambling, spending, hypersexuality, cross dressing, hiring cars (Ferraris, Bentleys etc) and luxury travel.

    Be warned, friends!

    • Thanks for the comment Peter. On online media, we take a very cautious approach to stating stats as information is constantly changing or being updated which would make our article outdated overnight. One out of seven is significant yet small so we could safely say that it is fairly uncommon at this point in time.

  2. Peter, I am so sorry to hear of your problems with the PD agonist. I myself have PD and was on Requip for three years and I too was definitely NOT myself. My hyper-sexuality almost cost me my marriage.

    I’d really like to hear from you as I’ve been in touch with certainly more than 1 out of 7 patients who have similar experiences!

    LSJR at MACintosh dot COMputer

  3. My husband is almost 60 and was diagnosed with PD almost 4 years ago. He has been on Requip for 3 years with a recent increase in dosage. Within weeks after starting Requip he became very hypersexual. It has negatively affected our marriage and I cannot get him to see how his behavior has changed. He refuses to switch to Mirapex, which his PCP suggested. I am at my wits end and do not know where to go from here. Any suggestions or ideas would be appreciated. Our marriage is at stake. Thank you.
    Kim

    • Hi Kim

      You obviously need to discuss this behavior with your husband and how it is disturbing you. Seeing a counselor may help as it will allow him to realize how his behavior has changed and how it is making you feel uncomfortable.

  4. Kim.
    Don’t think that switching to Mirapex will solve the problem.
    I take Mirapex for a non PD problem and it is causing me a lot of problems.
    I have taken it for just over 4 years in which time I almost left my wife for a more sexually adventurous woman, started uncontrollably cross dressing, shoplifting clothing items and seriously considering a sex change. This is not me yet I can’t stop it. Unfortunately the Mirapex is the only medication I have found to be useful in combating my primary problem, Restless Leg Syndrome. It has come very close to costing me my marriage and my home more than once. I am scared to go off it.

  5. My Former husband was diagnosed with Early on-set PD at 40, now, just 5 short years later, he has destroyed 2 marriges and at least one relationship with his son (he has 3)He was once worth an estimated $1million now, is bankrupt and facing foreclosures on many of his properties including the ones he resides in and the one I live in with his young children. I blame the entire situation on the Requip. He was warned by his Dr. about the side effects but once they took hold he couldn’t see them and would not, still will not listen to reason! He has lost everything he worked so hard to get and we have lost a father and a good person to this Requip drug, In addition, he suffers from hallucinations and hypersexual thoughts that are extremly inappropriate. (He truly believes our eldest son is having an affair with his 2nd wife and has confronted and accused both of them of it many times, our son is only 16!!) I feel there should be a massive lawsuit against the makers of this dangerous drug and others like it. No basic warning is enough> These PD pt.’s can’t see what’s happening to them and will not accept help before it’s too late because of the influence of the medication! I just don’t know how to go about the lawsuit process!

    • Hi Holly

      Lawsuits are not something we cover here. Side effects of any drug should be spotted by the patient, reported to the supervising doctor and a change of medication is usually warranted. Blaming a drug for behavior of a single person on this drug is not the answer now. Speak to the doctor. Have the medication changed. And take your husband in for some counseling.

  6. Our story involved Roprinerole and compulsive gambling. After finally getting someone to believe what we were reading on the web my husband was taken off it. We were $300,000 poorer and our marriage teetering on the brink.
    Gamblings best friend is deceit and lying and that was the hardest to bear.
    He has been gamble free for about 3 years now BUT it has just raised its ugly head again. I think this in line with an increase in his Sinimet so mabe the agonists arent the only culprits here which is in line with what I have just read.
    It makes sense that these drugs that are designed to create chemical changes in the brain and stimulate areas of activity have the potential to create havoc.
    1 in 7 is a HUGE percentage and I cant believe how muted the warnings are and how accurate this number is given many are still not aware of this.
    I guess one day it will be life threatening either to themselves or the public, then maybe there will be an accounting.
    And just for the record, my husband was 51 when diagnosed and treated with agonists so fits the profile perfectly.

  7. I was diagnosed with young onset PD at the age of 38, as a young woman it seems very rare. I have definately noticed a terrible trend in internet shopping at all hours of the day and night without control, it seems to make me feel better about myself, buying something to cheer myself up, but I have whittled away my insurance money over the last two years and have nothing to show for it except several Vivienne Westwood dresses…. so I am trying to take charge and am selling all my clothes and really try hard not to buy things but its complusive and I am compulsive and reckless by nature so hard to deal with.

    I also have a heightened libido and have behaved recklessly in this aspect as am single and find it very easy to pick up men, I find myself at 40 pregnant by someone much younger than me.

    I recognise the problems and fight daily not only to deal with the parkinsons it self but the compulsive disorders the drugs create. Sleeping is my worse problem – I simply cannot sleep at night and in the day find myself falling asleep in cafes on train anywhere really and the other night I woke up at 3am in the bath having fallen asleep for 3.5 hours….

    Any advice would be welcome – I just keep hoping I will be cured and will awake from this exhausting nightmare…..life wasn’t supposed to be this

    • Hi Butterfly

      Thank you for sharing your story with our readers. It is important to verify whether these compulsive tendencies are related to your personality and may not be due to the PD drugs. It would have been evident from earlier in life in some form or the other. You should discuss these findings with your doctor and discuss the therapeutic options. Counseling and behavioral therapy is one way of coping with this. As for your difficulty sleeping, please refer to these two articles :
      Insomnia in Parkinson’s disease
      Sleeping problems in Parkinson’s disease

  8. Diagnosed with PD at age 42; began Mirapex. Obsessive-compulsive behavior including internet poker (which lead to card rooms), internet porn (which lead to adultery), and intense, internalized anger. Marriage counseling with wife and individual sessions led to recognition of dopamine agonist as contributing factor (wouldn’t go so far as to say cause). Switching to levadopa was a good move for me. Professional help (psychologist; neurologist) was key to dealing with disease and the side effects of the medications…

  9. My husband was diagnosed with PD at age 52.
    On [DRUG NAME DELETED], a dopamine agonist, he shopped compulsively, used pornography constantly, started a sexual relation that has destroyed our marriage, become intensely, unexpectedly angry with me and our children, etc. etc. And no, he did not have any of these behaviors prior to starting on the dopamine agonist.
    Dr. Chris: dopamine agonists are horribly destructive. Your comments seems to minimize their impact. They may give a short-term benefit to the person with PD, but at the cost of destroying his family, ruining his finances, and demolishing his long-term prospects, since he will have demolished his support system and his financial resources.

    • Hi Miranda

      Thank you for your comments. Please understand that there are editorial guidelines that we have to adhere to. As an online publication, making any statement without conclusive scientific proof to back up our claims can mean serious litigation. Let us not deny (and I am being very bold by daring to say this) that pharmaceutical companies have the financial resources and resolve to eliminate any negative publicity especially if it cannot be conclusively validated.

      We aim to keep this publication running as a free service on limited resources and staff. The last thing that we can do is withstand any litigation from such a large entity. You can make this claim and remain anonymous if you wish. We cannot. We recently had another irate reader who accused us of colluding with the pharmaceutical companies, using quite foul language and asking readers to sue us for denying claims. If this is the type of retribution we face from the public just by helping them realize that such a problem exists, can you imagine what we could face with the pharmaceutical companies who are making millions if not billions from these products? We do now track IP addresses so that we can ban abusive readers.

      The managing company that owns this publication has questioned on several occasions whether this particular article should be removed. As a private company and not a non-profit organization like many other PD sites out there, we are in the most precarious situation should we dare to cross a certain boundary. We have allowed readers to post their comments and share their experiences on this article in the hope that it helps others. However it is unfair for any reader to comment on our restraint while choosing to remain anonymous. If you wish to mention a brand name, then at least offer your contact details for the manufacturer to follow up on.

      Nevertheless Miranda, thank you for your comment and more so for being polite when sharing your opinion and experiences.

  10. Although I was physically unable to stand upright–unmoving–for more than a few seconds for 30 years or more, I was diagnosed with Parkinson’s two years ago at age 65 when the tremors set in and became impossible to pass off as nothing serious.

    I haven’t started taking any medication, and the more I read, the less inclined I am to start.

    Have there been studies of people who decline treatment altogether?

    • Hi Cassie

      Cannot quote any specific studies but you can check Pubmed for any papers that may have been published. It is also helpful to check up on PD forums and so on.

  11. My family is on the brink of destruction. My husband (38)was dx. 2 years ago with PD and put on a dopamine agonist. He was the most upstanding man you could know before starting the drug and now has cheated on me several times and participates in internet porn. He is hopeless and feels he cannot control his behavior. I am disappointed in the lack of support for families like ourselves and the lack of education we have recieved in the side effects of these drugs. I fear I will soon be a single mother of 4 young children if things do not improve. You cannot imagine the pain our family has suffered as the result of a single medication.

  12. Hi,
    I am a 52yr old lady from the uk. I have had Parkinsons for 7 1/2 yrs and started my med regime on Requip from day 1. I have started to write my story, which is a horror story of lies, deceipt and destruction, compulsive behaviour, an addiction to sex,and a don’t care attitude to virtually everything in life. All i will say is that i used to be a happy loyal caring person, with high morells and standards, but ended up living and leading a double life, was caught out, resulting in destroying other people’s lives because of my unacceptable behaviour. My relationship of 24yrs with my partner has come to an end, but to be honest with you was pretty much over 10yrs ago so i cannot blame anything on that, but nevertheless it has destroyed my partner after everything came out into the open, and for that alone i am deeply ashamed. So, the common factor here is something that is being taken into my body, which wasn’t being taken in before i had Parkinsons. This is a very serious issue, and one which needs addressing and brought into the open, because lets face it, isn’t it hard enough coping with having PD, without being subject to probably much worse consequences just by taking a drug which is adminstered freely, but maybe unwisely. Personaly i think some drug manufacturers have a lot to answer for.

    Parkinson’s meds…”their aim was to help…their goal to destroy”

    Jill

  13. Hi, My husband was first diagnosed with PD when he was 31 yrs old!! He is now 65yrs old !!! The neurologist even said that he probably had in in his thirties! Having married him and searching out as many answers as we could we continued our lives as normally as we could. we had 3 children and life seemed to be ok until the natural progression of the disease manifested itself to a point where I could no longer keep his bizarre behaviour under wraps! I was accutely embarressed by certain incidents and as a young mother I would come home from doing the household shopping to find my husband either accessing the most disgusting porn on the internet or, drilling holes in the middle of the wall (for some new compulsive project) that he believed was NORMAL!!! I have stayed with him throughout every bizarre twist and turn of this most undignified and humiliating illness. He decided out of the blue that he wanted to live alone to pursue his interests in porn etc without my constant interferences. So in 2002 our lovely family home was sold and I along with my three children had to start all over again, to say life was tough is a gross understatement!! However a year later he was in such decline that he begged me to come back into his life, the children had accepted his abandonment and were quite against this, but I felt so sorry for him and for the last 9 yrs I have been his chief carer. I live 5 miles away and go every day from 8am to 8pm to care for him. Being able to have a night carer to help and the solace of coming back to my own home has been my salvation! if you can call it that! 5yrs ago my only son committed suicide at the age of 19yrs this was totally out of the blue, ie, no depression apparent, he had a girlfriend etc and there was no note, I just found him hanging from the loft access in his bedroom. To say I nearly lost it is an understatement,and not having the support of my husband due to his emotional decline from PD was a double whammy! But life goes on, it has to. What options are there?! So everyday I still look after my husbands every needs from tablet dispensing to bathing him shopping for him, decision making when he can’t or doesn’t want to. He is now in stage 5 of the illness, having now reached his 35th year of having thid evil illness and yes I have gone through all the side effects of the drugs with him from the hyper sexuality to the compulsive ones, Where do we go from here? I don’t know the answers. All I do know is that from the beautiful, funny, intelligent, man that I married and fell in love with, I now find myself washind his bottom after yet another incontinent episode, trying to help him enjoy what’s left of his life with the smallest amount of dignity that I can find in myself. I am NO Saint but if the tables were turned I would like to think there was someone out there for me!! I hope this helps anyone who has the unfortunate situation to cope with as I do.

  14. Michele Roberts,
    I can only say how much I admire you. You have gone over and above the call of duty and more. My husband was diagnosed with PD at 59 and we had a wonderful marriage. He was a loving, kind, witty, fun man but after DBS has completely changed. He is irritable, rigid in outlook, doesn’t believe in compromise has no feelings for me and his libido is non -existent. I have tried everything, counsellors, psychiatrists,but my husband doesn’t feel he needs to see anyone. He goes to auction houses and buys stuff we don’t need and starts jobs that he doesn’t finish. He never spends time just talking or relating to me. I never saw this coming and feel as if I have hit a brick wall at 200 KPH. I got no warning from his neuro that this could happen. And even his walking which was so good in the first 2 months after the op has now deteriorated badly. He keeps going to get adjustments made to his stimulater but it is a year later and he is still walking worse than he did before the op. The neuro says there is nothing wrong with his leads or stimulator…. Has anyone been through any of this and can give me any hope that he will improve both physically and psychiatrically. I could live with the physical effects of the disease but to have lost his love and support is killing me.

  15. Michelle – this almost replicates my life. My ex-husband was diagnosed with PD at age 42 and is now 57. When diagnosed at 42 the consultant explained he had had PD at least 8 yrs prior to diagnosis which made absolute sense when I thought about it. PD has ruined our marriage and life. Has devastated my daughter who has no relationship with her father and is totally ashamed of his behaviours. We lost 2 homes, our time share, were constantly in debt and I spent years afraid to answer our landline for fear of who was on the other end. My ex-husband suffers from hypersexuality, cross dressing, lying, stealing, sex aids, prostitution, recreational drugs (heroin, crack cocaine and weed) and has spent £180,000 on prostitutes and excessive spending; most of this money he stole from his own mother, family and friends. He has no conscience, is delusional and irrational. He has been on cabergeline (dopamine agonist) for at least 10 yrs. The neurologists know these drugs are lethal but still prescribe them which is completely wrong and unethical. My ex has been weened off cabergeline but still cannot let go of the feeling this drug gave him and wants the GP to prescribe it again. I lost everything and so did my daughter, due to his behaviours, which I could not live with anymore and in the end I ran away taking my daughter with me. It has been so painful, I lost my family home and family life and had to start again with nothing. My daughter is 22 yrs old and on anti-depressants, has had an eating disorder and been very depressed and needed counselling. I had to be on anti-depressants and was suicidal on several occasions. If I had not left I would not be here to tell my story today, either he would have killed me or I would have killed myself. He has married for a second time but has destroyed that relationship too and lost her also. He has borrowed thousands of pounds worth of money from friends that he cannot pay back, is in arrears with his mortgage and maxed out on his credit card. He has made me out to be a very bad person but its me he calls when he has a problem; he has told years of lies to friends and he is so convincing that they believe him. These PD drugs are evil and vile and ruin peoples lives. This man resembles absolutely nothing about the man I married 34 yrs ago and met 40 yrs ago, I do not recognise this man anymore and have to remain clinical about the situation and block it out. My daughter convinces herself her father is dead in order to cope with the pain.

  16. My husband is 35 years old and has been taking a dopamine agonist for his dx of early onset Parkinson’s. He has become very accusatory of me, his wife. He checks closets and windows because he says that I let men in the house. He has put out digital sound recorders in the driveway, to which he says that any sound is me having sex with people outside. He has now left and goes around telling all of these bizarre tales that he has thought up about me. It has been devastating to our family, as we have four small children and one on the way that is due in another month. He also recklessly went through our savings before I knew it, which prompted me to change our bank account info so that he could not access any money. He is now speaking with a lawyer to divorce me over all of his senseless, no evidence for accusations that he has come up with against me. This has totally devastated me and I’m scared to know what kind of effects it will have on our children. I’ve been forced to go through my pregnancy alone because of his bizarre behavior. Everyone is telling me this is due to the dopamine agonists. I’m curious how to get help, when he doesn’t think that he needs help and he is clearly ruining his entire life!!

  17. I was diagnosed with pd about 7 years ago. I didn’t worry about it . I should have. I was given Mirapex and azilect I started to play on line poker almost immediately and lost just about everything we had before my wife found out. she stopped my poker playing, so I started to w3atch porn. I started picking up prostitutes mostly to get crack, which I never did before. I have put myself in danger many times, but it doesn’t seem to bother. my family is at wits end. I am not the person I was. I have tried to commit suicide but both times I was stopped. are there any new drugs out there that I could try?
    thank you

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