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Psychiatric Times. Vol. 23 No. 9
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Dopamine Agonists, Pathologic Gambling, and Parkinson Disease

By Walter A. Brown, MD | September 1, 2006

Although pathologic gambling seems to be the complex behavior most likely to be triggered by dopamine(Drug information on dopamine) agonists, the possibility remains that other driven, complex behaviors--less troublesome and less likely to be complained about by patients or their family members--may arise with dopamine agonist treatment. Do some of the patients who receive these agents start browsing the Internet, shopping, or playing golf all day long? Friedman now routinely asks his patients with PD whether they have noticed any changes in their behavior or activities. And, given its potential for dire consequences, he specifically asks about gambling. His patients "never bring it up," he said, "but now I always ask."

Walter A. Brown, MD, is clinical professor of psychiatry at Brown Medical School in Providence, RI, and at Tufts University School of Medicine in Boston, and a practicing psychiatrist. This article was first published in Applied Neurology.

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References
1. Seedat S, Kesler S, Niehaus DJ, Stein DJ. Pathological gambling behaviour: emergence secondary to treatment of Parkinson's disease with dopaminergic agents. Depress Anxiety. 2000;11:185-186.
2. Molina JA, Sainz-Artiga MJ, Fraile A, et al. Pathological gambling in Parkinson's disease: a behavioral manifestation of pharmacologic treatment? Mov Disord. 2000; 15:869-872.
3. Driver-Dunckley E, Samanta J, Stacy M. Pathological gambling associated with dopamine agonist therapy in Parkinson's disease. Neurology. 2003;61:422-423.
4. Dodd ML, Klos KJ, Bower JH, et al. Pathological gambling caused by drugs used to treat Parkinson disease. Arch Neurol. 2005;62:1377-1381.
5. Kurlan R. Disabling repetitive behaviors in Parkinson's disease. Mov Disord. 2004;19:433-437.
6. Shaffer HJ, Hall MN, Vander Bilt J. Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. Am J Public Health. 1999;89:1369-1376.


 
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