Sema Ciftci Dogansen1,2, Ugur Cikrikcili3, Gonca Oruk4, Nilufer Ozdemir Kutbay5, Seher Tanrikulu6, Zeliha Hekimsoy7, Aysa Hadzalic8, Suheyla Gorar9, Tulay Omma10, Meral Mert2, Gulhan Akbaba11, Gulsah Yenidunya Yalin1, Fahri Bayram8, Mine Ozkan3, Sema Yarman1. 1. Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey. 2. Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 3. Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey. 4. Department of Internal Medicine, Division of Endocrinology and Metabolism, Izmir Ataturk Training and Research Hospital, Izmir, Turkey. 5. Department of Internal Medicine, Division of Endocrinology and Metabolism, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. 6. Department of Internal Medicine, Division of Endocrinology and Metabolism, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. 7. Department of Internal Medicine, Division of Endocrinology and Metabolism, Celal Bayar University Medicine Faculty, Manisa, Turkey. 8. Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey. 9. Department of Internal Medicine, Division of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey. 10. Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey. 11. Department of Internal Medicine, Division of Endocrinology and Metabolism, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey.
Abstract
CONTEXT: Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. OBJECTIVE: To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. RESULTS: Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. CONCLUSION: Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
CONTEXT: Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. OBJECTIVE: To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. RESULTS: Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. CONCLUSION: Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
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