The prevalence and clinical characteristics of hypersexuality in patients with Parkinson's disease following dopaminergic therapy: A systematic literature review

• Patients with Parkinson's disease (PD) on pharmacotherapy can develop hypersexuality.
• Hypersexuality has social and legal repercussions for the patients and their families.
• We conducted a systematic literature review on the prevalence of hypersexuality in PD.
• Data from 8 large studies (n = 268-3090) yielded a lifetime prevalence figure of 2.7%.
• Hypersexuality was associated with male gender and higher doses of dopamine agonists.

IntroductionA range of impulse control disorders have been identified as possible behavioural effects of brain dopamine replacement therapy (DRT) in patients with Parkinson's disease (PD). Among the behavioural problems associated with dysregulation of dopaminergic pathways underlying reward processing, hypersexuality carries significant social and legal repercussions, in addition to embarrassment for the patient with PD and his/her family. The present article evaluates the prevalence and characteristics of hypersexuality in the context of PD, focusing on the best available evidence.MethodsWe conducted a systematic literature review according to the Prisma guidelines on large-scale epidemiological studies (n > 250) assessing hypersexuality in patients with PD treated with DRT.ResultsOur systematic literature review identified 10 relevant studies characterised by medium–to-large sample sizes (n = 268-3090). Average lifetime prevalence of hypersexuality in patients with PD on DRT was found to be 2.7% (7.4% in patients on dopamine agonists). In general, hypersexuality was associated with male gender and higher doses of dopamine agonists. Other clinically relevant associations included younger age, earlier PD onset and history of behavioural symptoms prior to dopamine agonist use.ConclusionHypersexuality is not rare in patients with PD treated with DRT, particularly in those on dopamine agonists. These findings indicate that PD specialists should regularly screen and monitor for hypersexuality, paying particular attention to younger male patients, with an early PD onset and previous history of behavioural problems.