ICD Mechanism DA — RACP Adult Medicine MCQ

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ModerateNeurologyICD Mechanism DARACP Adult Medicine

A 60-year-old man with advanced Parkinson's on levodopa develops impulse control disorder (gambling) after adding pramipexole. What is the mechanism?

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Correct answer: E — D3 dopamine receptor overstimulation in mesolimbic pathway by dopamine agonists

Dopamine agonists overstimulate mesolimbic D3 receptors. ICD occurs in up to 17%. Reduce/cease DA, taper gradually (avoid DAWS).

Reference: AMH – 2025; eTG – 2025 – Neurology; MDS – 2023