Neurologists reassess dopamine agonists as first-line Parkinson's treatment amid impulse control concerns
Dopamine agonists like pramipexole, ropinirole, rotigotine, and apomorphine have traditionally been recommended as first-line therapy for younger Parkinson's patients (under 65) to delay levodopa use. However, growing concerns about their link to impulse control disorders (ICDs) such as gambling, hypersexuality, and compulsive shopping are prompting neurologists to reassess their role. At the 2026 French Language Neurology Days, two neurologists presented contrasting perspectives on whether dopamine agonists should remain a first-line treatment, weighing motor benefits against significant behavioral side effects.
Key quotes
Dopamine agonists such as pramipexole, ropinirole, rotigotine, and apomorphine have long been recommended as initial therapy for younger patients with Parkinson's disease
Concerns about their association with impulse control disorders (ICDs) — including gambling, hypersexuality, and compulsive shopping — have prompted a reassessment of their role in first-line treatment
At a session during the 2026 French Language Neurology Days, two neurologists outlined their perspectives on the treatment approach
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