Characteristics
of patients at increased risk for compulsive
gambling associated with taking Parkinson’s meds
Newswise — Patients with
Parkinson’s disease who are younger when they
develop the condition, have a personality trait
known as novelty-seeking or whose personal or family
history includes alcohol abuse may be more likely to
develop pathological gambling as a side effect of
medications used to treat their condition, according
to a report in the February issue of Archives of
Neurology, one of the JAMA/Archives journals.
Behaviors associated with
impulse control—including compulsive shopping,
hypersexuality, binge eating and pathological
gambling—have been associated with dopamine
agonists, medications used to treat Parkinson’s
disease.
In studies examining the
relationship between dopamine agonists and
compulsive gambling, the likelihood of gambling
problems was unrelated to the medication dosage.
This suggests that an underlying trait may interact
with the drugs and make an individual more
vulnerable to this adverse effect.
Valerie Voon, M.D., National
Institute of Neurological Disorders and Stroke,
Bethesda, Md., and colleagues compared the
characteristics of 21 patients with Parkinson’s
disease who developed pathological gambling habits
after beginning to take dopamine agonists with 42
patients with Parkinson’s disease who did not
develop compulsive behaviors.
The participants, who all
visited a clinic in Toronto, Canada, between June
2003 and October 2005, were examined by neurologists
and completed assessment scales that measured their
levels of impulsivity, substance abuse, mood and
anxiety disorders. An additional inventory measured
the extent to which the patients displayed
novelty-seeking traits, characterized by impulsive
and risk-taking behavior and excitement in response
to new experiences.
“In keeping with our
hypothesis, patients with Parkinson’s disease who
developed pathological gambling when receiving
dopamine agonists had a younger age at Parkinson’s
disease onset, higher novelty-seeking scores, a
personal or immediate family history of alcohol use
disorders and impaired planning on an impulsivity
scale,” the authors write.
“A robust association was found
with medication-induced mania [a psychiatric
disorder involving excessive physical and mental
activity and impulsive behavior].” Pathological
gambling was also weakly linked to younger age,
Parkinson’s disease that began in the brain’s left
hemisphere and a high score on a scale measuring the
impulsiveness of behaviors.
