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Punding

Punding refers to a possible symptom of dopamine dysregulation syndrome.

It is is the repetition of complex motor behaviours such as collecting or arranging objects.

It is compulsive performance of repetitive, mechanical tasks, such as assembling and disassembling, collecting, or sorting household objects. 

Originally described complex prolonged, purposeless, and stereotyped behaviour in phenmetrazine and chronic amphetamine users.

It has been described in Parkinson’s disease.

It is mainly seen in cases of patients being treated with dopaminergic drugs.

It has also been described in methamphetamine and cocaine users, as well as in some patients with gambling addictions, and hypersexuality.

People engaging in punding find immersion in such activities comforting.

The activities may serve no purpose, and patients generally find it very frustrating to be diverted from them. 

Individuals are not generally aware that there is a compulsive element to their behavior.

Interrupting can lead to anger or rage, sometimes to the point of violence.

Punding is linked primarily to an overstimulation of the dopamine D1 receptors and, to a lesser extent, of D2 receptors, leading  to substantial changes in the striatum, and the nucleus accumbens, some of the main dopaminergic areas of the brain regulating psychomotoric functions and reward mechanisms. 

Treatment  the same as for the dopamine dysregulation syndrome, but will vary depending on the cause: for patients with Parkinson’s disease, doses of dopaminergic drugs such as levodopa must be reduced.

Effective medications are atypical antipsychotics like quetiapine or clozapine.

Amantadine has also reported to be effective.

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