Hypersexuality in Parkinson’s disease
Marcin Kopka
Hypersexuality is defined as a continuous, devastating and persistent need associated with human sexual life. It belongs to a group of complex behavioural disorders referred to as impulse control disorders. It is estimated that the incidence of hypersexuality in people with Parkinson’s disease ranges from 2% to 4%. In patients treated for Parkinson’s disease, hypersexuality is diagnosed more often than in the general population. The pathophysiology of hypersexuality in patients with Parkinson’s disease is not fully understood. It is suggested that the treatment of the underlying disease plays a significant role. In the literature, the majority of reports of hypersexuality cases have been linked to treatment with dopamine agonists, however, cases treated with levodopa, monoamine oxidase inhibitors or deep brain stimulation have also been reported. The risk factors of hypersexuality in patients with Parkinson’s disease include male gender, early onset of the disease and treatment with dopamine agonists. Little is known about the optimal management strategies for Parkinson’s disease patients with hypersexuality. Two long-term follow-up studies, although conducted in small groups, have indicated that discontinuation of dopamine agonists leads to full remission or clinically significant reduction of the symptoms of hypersexuality. Further studies are needed to determine how to successfully treat hypersexuality in patients with Parkinson’s disease.