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Impulse control disorder — DGM MCQ

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ModerateMovement disordersImpulse control disorderDGM

A 72-year-old man with Parkinson's disease starts gambling online and spending impulsively. This began after a dopamine agonist was titrated. His wife reports increased sexual preoccupation. Current medicines include pramipexole and co-careldopa. What is the most likely diagnosis?

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Correct answer: E — Dopamine agonist-related impulse control disorder

New gambling, compulsive spending and hypersexuality after dopamine agonist titration are typical of impulse-control disorder. Frontotemporal dementia is possible but the timing with dopamine agonist is key; mania and delirium would have broader syndromic features, and this is not normal personality change. Patients and families should be warned about impulse-control effects before dopamine agonists.

Reference: NICE NG71