Some Parkinson's Disease Meds May Up Risk of Compulsive Behaviors

Parkinson's meds may increase pathological gambling and other impulse control disorders
Parkinson's meds may increase pathological gambling and other impulse control disorders

Neurologists have linked medications used for Parkinson's disease with impulse control disorders such as pathological gambling, compulsive buying, hypersexuality, and binge eating in some patients. Findings from the review article are published in Expert Review of Neurotherapeutics.

A previous study reported that ~14% of Parkinson's disease patients experience at least one impulsive control disorder, which may be more common in men. Men are more likely to exhibit hypersexuality and pathological gambling whereas women may be more likely to exhibit compulsive eating and shopping. 

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Loyola University researchers found that the main risk factor for impulsive control disorders is the use of dopamine agonists, which help manage tremors and other Parkinson's symptoms. Drugs in this class include Mirapex (pramipexole; Boehringer Ingelheim) and Requip (ropinirole; GlaxoSmithKline). Other risk factors include younger age, smoking, alcohol abuse, and traits such as impulsivity, obsessive-compulsive disorder, depression, and anxiety. 

Study authors further review the latest evidence in treating impulse control disorders in patients with Parkinson's disease. In general, treatment should be individualized and caution should be taken when patients are taken off dopamine agonists as they can experience withdrawal symptoms (eg, anxiety, panic attacks, depression, irritability, fatigue).

Other treatment alternatives to help control impulse control disorders include antidepressants, atypical antipsychotics, and antiepileptic drugs. Non-pharmacologic treatments include cognitive behavioral therapy and deep brain stimulation. 

For more information visit nih.gov.

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