Management of punding in Parkinson's disease: an open-label prospective study

J Neurol. 2011 Apr;258(4):656-60. doi: 10.1007/s00415-010-5817-8. Epub 2010 Nov 12.

Abstract

Punding, a peculiar stereotyped behavior characterized by intense fascination with complex, excessive, non-goal-oriented, repetitive activities, is a quite rare condition complicating Parkinson's disease (PD). It is triggered by dopaminergic therapy and could have a strong impact on patient quality of life. No study has specifically investigated medical management of this condition, and only a few anecdotal reports have provided therapeutic hints. Given the suggested similarities to drug-induced dyskinesias, we have previously suggested a multistep algorithm for management of punding. We conducted a prospective open-label study on ten PD punders aimed at testing its validity. In two cases, reduction of levodopa therapy was efficacious; amantadine was effective in controlling punding in four cases; in the remaining cases, quetiapine was employed, with mild efficacy in two cases.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Amantadine / therapeutic use*
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Dibenzothiazepines / therapeutic use*
  • Female
  • Humans
  • Levodopa / adverse effects
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy
  • Prospective Studies
  • Quetiapine Fumarate
  • Stereotypic Movement Disorder / chemically induced
  • Stereotypic Movement Disorder / drug therapy*

Substances

  • Antipsychotic Agents
  • Dibenzothiazepines
  • Quetiapine Fumarate
  • Levodopa
  • Amantadine