OBJECTIVE: To determine the frequency of new-onset compulsive gambling or hypersexuality among regional patients with Parkinson disease (PD), ascertaining the relationship of these behaviors to PD drug use. PATIENTS AND METHODS: We retrospectively reviewed the medical records of patients from 7 rural southeastern Minnesota counties who had at least 1 neurology appointment for PD between July 1, 2004, and June 30, 2006. The main outcome measure was compulsive gambling or hypersexuality developing after parkinsonism onset, including the temporal relationship to PD drug use. RESULTS: Of 267 patients with PD who met the study inclusion criteria, new-onset gambling or hypersexuality was documented in 7 (2.6%). All were among the 66 patients (10.6%) taking a dopamine agonist. Moreover, all 7 (18.4%) were among 38 patients taking therapeutic doses (defined as >/=2 mg of pramipexole or 6 mg of ropinirole daily). Behaviors were clearly pathologic and disabling in 5: 7.6% of all patients taking an agonist and 13.2% of those taking therapeutic doses. Of the 5 patients, 2 had extensive treatment for what was considered a primary psychiatric problem before the agonist connection was recognized. CONCLUSION: Among the study patients with PD, new-onset compulsive gambling or hypersexuality was documented in 7 (18.4%) of 38 patients taking therapeutic doses of dopamine agonists but was not found among untreated patients, those taking subtherapeutic agonist doses, or those taking carbidopa/levodopa alone. Behaviors abated with discontinuation of agonist therapy or dose reduction. Because this is a retrospective study, cases may have been missed, and hence this study may reflect an underestimation of the true frequency. Physicians who care for patients taking these drugs should recognize the drug's potential to induce pathologic syndromes that sometimes masquerade as primary psychiatric disease.
OBJECTIVE: To determine the frequency of new-onset compulsive gambling or hypersexuality among regional patients with Parkinson disease (PD), ascertaining the relationship of these behaviors to PD drug use. PATIENTS AND METHODS: We retrospectively reviewed the medical records of patients from 7 rural southeastern Minnesota counties who had at least 1 neurology appointment for PD between July 1, 2004, and June 30, 2006. The main outcome measure was compulsive gambling or hypersexuality developing after parkinsonism onset, including the temporal relationship to PD drug use. RESULTS: Of 267 patients with PD who met the study inclusion criteria, new-onset gambling or hypersexuality was documented in 7 (2.6%). All were among the 66 patients (10.6%) taking a dopamine agonist. Moreover, all 7 (18.4%) were among 38 patients taking therapeutic doses (defined as >/=2 mg of pramipexole or 6 mg of ropinirole daily). Behaviors were clearly pathologic and disabling in 5: 7.6% of all patients taking an agonist and 13.2% of those taking therapeutic doses. Of the 5 patients, 2 had extensive treatment for what was considered a primary psychiatric problem before the agonist connection was recognized. CONCLUSION: Among the study patients with PD, new-onset compulsive gambling or hypersexuality was documented in 7 (18.4%) of 38 patients taking therapeutic doses of dopamine agonists but was not found among untreated patients, those taking subtherapeutic agonist doses, or those taking carbidopa/levodopa alone. Behaviors abated with discontinuation of agonist therapy or dose reduction. Because this is a retrospective study, cases may have been missed, and hence this study may reflect an underestimation of the true frequency. Physicians who care for patients taking these drugs should recognize the drug's potential to induce pathologic syndromes that sometimes masquerade as primary psychiatric disease.
Authors: Robert G Holloway; Ira Shoulson; Stanley Fahn; Karl Kieburtz; Anthony Lang; Kenneth Marek; Michael McDermott; John Seibyl; William Weiner; Bruno Musch; Cornelia Kamp; Mickie Welsh; Aileen Shinaman; Rajesh Pahwa; Lynn Barclay; Jean Hubble; Peter LeWitt; Janis Miyasaki; Oksana Suchowersky; Mark Stacy; David S Russell; Blair Ford; John Hammerstad; David Riley; David Standaert; Frederick Wooten; Stewart Factor; Joseph Jankovic; Farah Atassi; Roger Kurlan; Michel Panisset; Ali Rajput; Robert Rodnitzky; Cliff Shults; Giselle Petsinger; Cheryl Waters; Ronald Pfeiffer; Kevin Biglan; Leona Borchert; Amy Montgomery; Laura Sutherland; Carolyn Weeks; Maryan DeAngelis; Elspeth Sime; Susan Wood; Carol Pantella; Mary Harrigan; Barbara Fussell; Sandra Dillon; Barbara Alexander-Brown; Pamela Rainey; Marsha Tennis; Elke Rost-Ruffner; Diane Brown; Sharon Evans; Debra Berry; Jean Hall; Theresa Shirley; Judith Dobson; Deborah Fontaine; Brenda Pfeiffer; Alicia Brocht; Susan Bennett; Susan Daigneault; Karen Hodgeman; Carolynn O'Connell; Tori Ross; Karen Richard; Arthur Watts Journal: Arch Neurol Date: 2004-07
Authors: Felix Javier Jiménez-Jiménez; Youssef Sayed; Miguel Angel García-Soldevilla; Beatriz Barcenilla Journal: Ann Pharmacother Date: 2002 Jul-Aug Impact factor: 3.154
Authors: Daniel O Claassen; Wery P M van den Wildenberg; K Richard Ridderinkhof; Charles K Jessup; Madaline B Harrison; G Frederick Wooten; Scott A Wylie Journal: Behav Neurosci Date: 2011-08 Impact factor: 1.912