Parkinson’s drugs linked to impulse control disorders

Parkinson’s drugs linked to impulse control disorders

NEW YORK (Reuters Health) – Drugs for Parkinson’s disease can sometimes cause patients to have difficulty controlling their impulses, researchers say.

The medicines, known as dopamine receptor agonist drugs, were linked with higher risks for pathological gambling, hypersexuality and compulsive shopping in a new study.

Cases of these severe impulse control disorders linked to the drugs have been reported for more than 10 years, and in many cases the abnormal behavior stops when patients stop taking the medications, lead author Thomas J. Moore of the Institute for Safe Medication Practices in Alexandria, Virginia, and colleagues write in their report of the study.

The Parkinson’s Disease Foundation says on its website that in one earlier study, dopamine agonists were linked with compulsive behaviors in up to 14 percent of patients.

To further investigate the connection, Moore’s team analyzed 2.7 million serious drug side effects reported in the FDA Adverse Event Reporting System between 2003 and 2012 in the U.S. and 21 other countries. They identified 1,580 impulse control disorder events, 710 linked to dopamine agonist drugs and 870 associated with other drugs.

The dopamine agonists were most often prescribed for Parkinson’s disease but were also sometimes prescribed for patients with restless leg syndrome.

Dopamine agonist drugs were 277 times more likely to result in a report of specific impulse control symptoms than other drugs, Moore told Reuters Health by email.

“This tells you that reports associating a drug with pathological gambling or hypersexuality are extremely rare, except for this group of drugs,” he said.

That’s a large increase in risk, and the actual risk could in fact be higher, since these data rely on official reports of drug side effects, according to Joshua J. Gagne of Brigham and Women’s Hospital and Harvard Medical School in Boston.

Gagne wrote an editorial accompanying the new results.

There was also a link between impulse control disorders and antidepressants or antipsychotics, but not as powerful as the link with the Parkinson’s drugs.

One characteristic of Parkinson’s disease is a reduction in the amount of the neurotransmitter dopamine in the brain. Dopamine agonist drugs, which include pramipexole (Mirapex), ropinirole, cabergoline, bromocriptine (Cycloset), rotigotine and apomorphine (Apokyn)
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Parkinson’s drugs linked to impulse control disorders – Reuters

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