Punding

The term was originally coined to describe complex, prolonged, purposeless (unproductive), and stereotyped behaviour in phenmetrazine and chronic amphetamine users, by Swedish forensic psychiatrist G. Rylander, in 1968.

[5] For example, punding may consist of activities such as collecting pebbles and lining them up as perfectly as possible; disassembling and reassembling wristwatches; or conducting extended monologues devoid of context.

[8] Punding has been linked primarily to an imbalance in dopamine D1 receptor and D2 receptors activation within the cortico-basal-ganglia-thalamo-cortical loop[9], which has been proposed to lead to substantial changes in the striatum (especially its dorsal and ventral areas) and the nucleus accumbens, some of the main dopaminergic areas of the brain regulating psychomotoric functions and reward mechanisms.

On the other hand, it has been noted that patients with Parkinson's disease treated with dopaminergic drugs that selectively activate only D3 receptors are the least likely to develop punding.

[11] While treating the root cause is considered to be the mainstay of treatment, cases where a reduction in the consumption of dopaminergic substances of any kind (medications or drugs) is unacceptable (such as when reducing the dose of levodopa in a patient with Parkinson's disease would lead to an unacceptable worsening of the symptoms) are the type of situations when medications are most frequently considered, usually as add-on therapies.