Understanding Impulse Control Disorder in Parkinson’s Disease

When we think of Parkinson’s disease (PD), symptoms like tremors, stiffness, and balance issues often come to mind. However, Parkinson’s doesn’t only affect movement—it can also impact behavior, emotions, and decision-making. One lesser-known but important condition associated with PD is Impulse Control Disorder (ICD).

What is Impulse Control Disorder? 
​Impulse Control Disorder refers to a group of behavioral conditions where a person struggles to resist urges or impulses that may be harmful to themselves or others. In the context of Parkinson’s disease, ICD is most often a side effect of certain medications used to treat motor symptoms—particularly dopamine agonists.
People with ICD may engage in behaviors like:

•    Compulsive gambling
•    ​Hypersexuality
•    Excessive shopping or spending
• ​   Binge eating
•    Hoarding or collecting

These behaviors can start subtly and become more intense over time. What makes ICD particularly challenging is that individuals may not realize these actions are linked to their Parkinson’s medication—or that the behavior is even a problem until it begins affecting finances, relationships, or emotional well-being.

What Causes ICD in Parkinson’s? 
​ICD in PD is most commonly linked to dopaminergic medications, especially dopamine agonists like pramipexole (Mirapex) or ropinirole (Requip). These medications help with movement symptoms by stimulating dopamine receptors in the brain, but they can also affect the brain’s reward system. This can increase the drive for pleasure-seeking behaviors, leading to problems with self-control.

Not every person with Parkinson’s who takes these medications will experience ICD. However, certain risk factors can increase the likelihood, including:

•   A personal or family history of addiction or impulsivity
•   Younger age at Parkinson’s onset
•   Depression or mood disorders
•   Higher doses of dopamine agonists

Recognizing the SignsSpotting ICD early is key. Loved ones may notice changes before the person affected does, such as:

• Secretive behavior or hiding purchases
• Unexplained financial strain
• Spending more time online or on phones for gambling or shopping
• Mood changes when asked about certain behaviors

If you or a loved one starts showing signs of impulsive or compulsive behavior, don’t ignore it—talk to your neurologist or Parkinson’s care team.

Treatment and Support
The good news is that ICD is manageable. Treatment often includes:

• Adjusting medications, particularly reducing or switching off dopamine agonists
• Cognitive behavioral therapy (CBT) to address thought patterns and coping strategies
• Support groups to talk openly with others who understand the experience​

At the Parkinson’s Association of Southwest Florida, we believe in treating the whole person—not just motor symptoms. That means providing education and support for behavioral and emotional challenges like ICD as well.

Final Thoughts
Impulse Control Disorder is a real and distressing part of the Parkinson’s experience for some individuals—but help is available. If you or someone you love is experiencing sudden or uncontrollable urges, it’s not a character flaw—it’s a treatable side effect. Let’s keep the conversation going and ensure no one navigates Parkinson’s alone.

For more resources, support groups, or to speak with someone who understands, please visit www.parkinsonassociationswfl.org or call 239-417-3465.
For more than 25 years, PASWFL has provided free, high-quality services and programs to individuals and families affected by Parkinson’s disease in Southwest Florida.
Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:

• Wellness and fitness classes
• Speech and cognitive therapy
• Art and music therapy
• Educational seminars
• Support for care partners
• One-on-one resource navigation

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.

Take the First Step Toward Living Well
If you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.
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To learn more, visit www.parkinsonassociationswfl.org and discover the power of support, education, and community.