Impulse Control Side Effects
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anonymous Asks ...
My husband has early onset parkinsons and is taking pramipexole. We were warned that one of the possible side effects of the treatment was a risk of impulse control disorders and we were told that we were to be on the lookout for certain types of behaviors. Well, my husband is now showing real differences in eating and sexual behaviors (his appetites are insatiable) and this is a difference from before. I told him that he should tell his doctor about it but he says that he feels good now and he doesn’t want to change his medication around. He says that if these side effects are the price he has to pay he is glad to do it. I am not sure. Should we be worried that he is having these ICD symptoms? Are things going to get worse or is he right to decide whether or not he finds the side effects acceptable?
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Dr. Lani Chin Says ...
It sounds like you and your husband are going through a really difficult time. I would recommend first and foremost that your husband make a visit to his medical doctor.
Although he is ok with these side effects, his doctor needs to know what's going on. It sounds like what he is exhibiting is on the verge of "reckless" behavior but this can easily turn into "risky" behavior. Having an insatiable appetite for food or sex becomes risky when your husband begins making decisions that impact his functioning. An example of this might be calling you to have sex during his lunch break or wanting to have sex in the morning on a regular basis before work which could affect your attendance at work. The consequences of either of these scenarios could be seen as minor, but if they continue there could be consequences to your husband's work life and functioning.
When these behaviors become reckless is when his impulses lead to impulsive sex. This could be having sex with prostitutes or getting drunk and having a one night stand. This might sound like a stretch since you say these behaviors are not typical for your husband, but I want you to know the hallmarks of when impulse disorders become real problems. Again, I recommend your husband see a medical doctor. Just because he reports an increase in impulsive behavior doesn't mean that his doctor is going to do something to make the impulses go away right away, but his doctor does need to know. I hope that the examples I provided help you to see when your husband's behavior could be described as dangerous and needing immediate attention.
