Parkinson's Medications Tied to Impulse Control Disorders

Impulse control disorders strongly associated with dopamine agonist use.
Impulse control disorders strongly associated with dopamine agonist use.

HealthDay News — For patients with Parkinson's disease (PD), dopamine agonist (DA) use is associated with incidence of impulse control disorders (ICDs) in a dose-effect relationship, according to a study published online June 20 in Neurology.

Jean-Christophe Corvol, MD, from the Assistance Publique Hôpitaux de Paris, and colleagues used data from a multicenter longitudinal cohort of consecutive patients with PD with no more than 5 years of disease duration at baseline. Patients were followed up annually up to 5 years to examine the longitudinal dose-effect correlation between dopamine replacement therapy and ICDs. During face-to-face semi-structured interviews with movement disorder specialists, ICDs were evaluated. 

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The researchers found that 86.6% of the 411 patients took a DA at least once since disease onset. The 5-year cumulative incidence of ICDs was 46.1% in 306 patients without ICDs at baseline (DA ever-users, 51.5%; DA never users, 12.4%). There was an increase in the prevalence of ICDs from 19.7% at baseline to 32.8% after 5 years. There was a correlation for ICDs with ever DA use (prevalence ratio, 4.23). There were independent associations for lifetime average daily dose and duration of treatment with ICDs, with significant dose-effect relationships. After discontinuation of DA, ICDs progressively resolved.

"ICDs were strongly associated with DA use with a dose-effect relationship; both increasing duration and dose were associated with ICDs," the authors write. "ICDs progressively resolved after DA discontinuation."

Several authors disclosed financial ties to the pharmaceutical industry.

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