#29 When medicines change our behaviour – Michele Fusaroli

Drug Safety Matters

Medicines can affect our personality in positive ways, but they may also lead to destructive behaviours that can damage our relationships, finances, and overall quality of life. Michele Fusaroli from the University of Bologna explains how to diagnose and treat drug-induced impulse control disorders.

Tune in to find out:

• Which medicines may cause impulsivity
• What the ‘four knights’ of impulsivity are
• How patient stories can help detect these conditions

Want to know more?

This review by Daniel Weintraub summarises twenty years of research on impulse control disorders in Parkinson’s disease.
In 2003, Driver-Dunckley and colleagues in the US published the first case series linking pathological gambling to dopamine agonists.
In 2016, the US Food and Drug Administration warned about impulse-control problems associated with the antipsychotic drug aripiprazole.
Michele and colleagues in Italy have investigated the mechanisms and burden of drug-induced impulsivity.
In their 2024 guidelines for managing impulsivity in Parkinson's disease, an expert consensus group highlighted the pivotal role of caregivers and of psychosocial interventions.
Finally, these are the Drug Safety Matters episodes cited in the interview:

• Catching black swans
• When drugs damage the liver
• Empowering patients as partners
• Why we should listen to patients

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Chapters

1. #29 When medicines change our behaviour – Michele Fusaroli (00:00:00)

2. Intro (00:00:15)

3. Welcome, Michele! (00:01:53)

4. Body versus mind (00:02:47)

5. Tamoxifen and brain fog (00:05:38)

6. Drug-induced impulse control disorders (00:06:36)

7. Drugs and mechanisms (00:08:46)

8. Frequency of impulse control disorders (00:09:58)

9. Risk factors (00:11:07)

10. Impact on quality of life (00:11:45)

11. First identification (00:14:16)

12. Third-generation antipsychotics (00:16:02)

13. Diagnosis (00:19:00)

14. Coping strategies (00:20:45)

15. Assessing impulsivity reports (00:23:52)

16. Final advice (00:26:40)

17. Outro (00:29:01)