Parkinson’s disease

Impulse-control disorders common in Parkinson’s patients taking dopamine agonists

Researchers find that after five years of follow-up, more than half of people taking dopamine agonists for management of Parkinson’s disease developed impulse-control disorders.

Use of dopamine agonists (DAs) in people with Parkinson’s disease is strongly associated with the development of impulse-control disorders (ICDs), according to the results of a study published in Neurology (20 June 2018)[1].

The research included 411 patients who had the disease for less than five years, 86.6% of whom had taken at least one DA since disease onset.

At five years’ follow-up, 51.5% of those exposed to DAs had experienced an ICD, such as pathological gambling or compulsive shopping, eating or sexual behaviours, compared with a rate of 12.4% in those never exposed to DAs. The researchers also found a significant dose–response relationship between DA use and ICDs, and that ICDs resolved after DA discontinuation. In contrast, there was no relationship between other drugs for Parkinson’s disease and ICDs.

“Given the high cumulative incidence of ICDs in patients with PD, these adverse effects should be carefully monitored in patients ever treated with DAs,” the researchers concluded. Tools to screen patients at high risk of developing ICDs would be beneficial, they added.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20205298

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