Parkinson’s Drugs Can Increase Gambling, Other Compulsions

Gambling, shopping, binge eating, and other compulsive behaviors are more likely to occur in Parkinson’s disease patients who take commonly prescribed drugs to control the ailment, a new study finds.

Researchers at Loyola School of Medicine in Maywood, Ill., reviewed several studies, including a large, national one that finds about 14 percent of Parkinson’s disease patients experience at least one impulse control disorder. The study also found that such compulsive disorders were more likely to occur in men, who most often were hypersexual or gambled. Women, on the other hand, were more likely to shop and eat compulsively.

The primary risk factor for these impulsive disorders is the use of a class of Parkinson’s disease medications called dopamine agonists, which help control tremors and other Parkinson’s symptoms. These drugs include pramipexole (Mirapex) and ropinirole (Requip).  Other risk factors include younger age, smoking, alcohol abuse and personality traits such as impulsivity, obsessive-compulsive disorder, depression and anxiety.

According to the authors, such compulsive disorders are difficult to treat, no guidelines exist, and since they are difficult for patients to recognize, the problem may be underreported.  Switching, reducing or discontinuing the medications can be challenging because patients may suffer withdrawal symptoms, and also they don’t want their tremors to worsen.

In the article, which appears in Expert Review of Neurotherapeutics, the researchers offer non-drug alternatives for Parkinson’s disease treatment, as well as medications that might help treat the compulsive disorders. Family support and understanding is also essential, they note.