Compulsive behaviors are
common from Parkinson treatment
Newswise — People treated for
Parkinson disease are prone to pathologic gambling, hypersexuality,
and compulsive shopping, according to research that will be
presented at the American Academy of Neurology 58th Annual Meeting
in San Diego, Calif., April 1 – 8, 2006.
Reports have been growing in the
past several years of compulsive behavior among patients with
Parkinson disease who receive levodopa or dopamine agonists, the
mainstays of Parkinson treatment. To examine the true extent of the
problem, Valerie Voon, MD, of the National Institute for Neurologic
Diseases and Stroke in Bethesda, MD, and her colleagues, conducted a
prospective survey in almost 300 Parkinson patients, asking about
pathologic gambling, hypersexuality, and compulsive shopping. They
followed up with in-depth psychiatric interviews for those reporting
any of the three compulsive behaviors.
Among their sample, pathologic
gambling started in 10 patients (3.4 percent) after they began
treatment, which is double the number expected based on
population-wide surveys. These patients had lost an average of
$150,000. Hypersexuality was seen in seven patients, and compulsive
shopping in two.
The researchers examined the
medications patients were taking to see if these influenced risk for
compulsive behavior. They found that almost all patients who
developed these behaviors were receiving both levodopa and a
dopamine agonist. Patients on levodopa alone were much less likely
to develop a compulsive behavior. No single dopamine agonist was
more likely than another to be associated with these behaviors. One
or another form of compulsive behavior was seen in 6 percent of the
entire patient population, and 16 percent of those receiving both
types of medication.
Voon cautions that these results
must be interpreted with care, since the patients were drawn from a
large specialty care center, and may not be representative of the
Parkinson population as a whole. “Larger multi-center trials are
required to definitively determine the differences between Parkinson
patients and the general population,” Voon said. “Nonetheless,
patients and caregivers should be aware of these commonly hidden
behaviors.”
The American Academy of Neurology,
an association of more than 19,000 neurologists and neuroscience
professionals, is dedicated to improving patient care through
education and research. A neurologist is a doctor with specialized
training in diagnosing, treating and managing disorders of the brain
and nervous system such as Alzheimer disease, epilepsy, multiple
sclerosis, Parkinson disease, and stroke.