| Eleven
patients with Parkinson's disease (PD) developed pathological
gambling behavior following dopamine agonist therapy, a
drug therapy to control movement problems caused by Parkinson's
disease, according to a study posted online today which
will appear in the September print issue of Archives of
Neurology, one of the JAMA/Archives journals.
Parkinson's
disease, a degenerative disorder marked by the death of
the neurons of an area of the brain called the substantia
nigra, is primarily treated by drugs that restore or improve
brain chemical
signaling system dependent on dopamine, according to background
information in the article. Brain dopamine, a chemical
that helps regulate movement, balance and walking, also
plays a central role in the behavioral reward system,
reinforcing a myriad of behaviors. It has been implicated
in the reward of gambling behavior.
M.
Leann Dodd, M.D., of the Mayo Clinic, Rochester, Minn.,
and colleagues, present reports of eleven patients seen
and evaluated between 2002 and 2004 in the Mayo movement
disorders clinic with Parkinson's disease who had recently
developed pathological gambling and review similar cases
from the medical literature. Pathological gambling is
defined as a failure to resist gambling impulses despite
severe personal, family or vocational consequences.
The
researchers describe the clinical features of 11 patients.
Pathological gambling developed in seven of these 11 patients
within one to three months of either reaching the maintenance
dose, or
increasing their dose of a dopamine agonist, the researchers
report. While the other four patients did not report compulsive
gambling until 12 to 30 months after initiating the therapy,
in all four the gambling resolved within months of discontinuing
agonist treatment. "The relationship of pathological
gambling to dopamine agonist therapy in these cases is
striking," the researchers write.
Six
of the patients developed additional behavioral problems
simultaneously with the pathological gambling, which resolved
as the gambling subsided. These included compulsive eating,
increased alcohol consumption, increased spending and
hypersexuality.
"In
summary, dopamine agonist drugs appear to be uniquely
implicated as a cause of pathological gambling,"
the authors conclude. "Both our series and prior
reports have especially linked this to administration
of the selective dopamine D3 agonist pramipexole. Disproportionate
stimulation of dopamine D3 receptors might be responsible
for pathological gambling in these PD cases."
Source:
http://www.medicalnewstoday.com/medicalnews.php?newsid=27312
|
