Parkinson's drugs up risk of gambling, compulsive shopping

Drugs commonly prescribed to treat Parkinson's disease may increase the risk of impulse control disorders such as pathological gambling, compulsive shopping, binge eating and hypersexuality in some patients, a new study has claimed.

These impulse control disorders (ICDs) can have disastrous personal, professional and financial consequences if not recognised or treated, according to researchers from the Loyola University Chicago in the US.

A previous study found that approximately 14 per cent of Parkinson's disease patients experience at least one ICD. The disorders are more common in men.

Men are more likely to display hypersexuality and pathological gambling, while women are more likely to exhibit compulsive eating and buying.

Potentially catastrophic consequences include financial ruin, divorce and loss of employment, researchers said.

Patients often lack insight and underestimate the presence and severity of ICDs and related conditions. ICDs are probably more prevalent in Parkinson's disease patients than previously reported, they said.

The primary risk factor for ICDs is the use of a class of Parkinson's disease medications called dopamine agonists, which help control tremors and other Parkinson's symptoms. These drugs include pramipexole and ropinirole.

Other risk factors include younger age, smoking, alcohol abuse and personality traits such as impulsivity, obsessive-compulsive disorder, depression and anxiety.

Management of ICDs is particularly difficult and no treatment guidelines for ICDs in Parkinson's patients are available, researchers said.

Treatment should be individualised, and careful selection of specific interventions is critical. Treatments that have been considered include switching, reducing or discontinuing Parkinson's medications.

Researchers suggest alternative treatment strategies for Parkinson's disease and medications that may help control ICDs, such as antidepressants, atypical antipsychotics and antiepileptic drugs.

Other potential nondrug treatments include cognitive behavioural therapy and a "brain pacemaker" called deep brain stimulation, researchers said.

The study was published in the journal Expert Review of Neurotherapeutics.