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Parkinson’s Drugs Linked to Dangerous Compulsions

Anyone who has a loved one that’s affected by Parkinson’s disease naturally breathes a sigh of relief when a medication regiment is able to ease symptoms like trembling, limb stiffness and loss of balance.

Unfortunately, those same medications could be causing unusual and sometimes aggressive behaviors that the loved one has never exhibited, like compulsive shopping or gambling or maybe even inappropriate behavior.

Study Raises Concerns of Drugs’ Effects

Thanks to a study published in the fall in JAMA Internal Medicine, more doctors are advising patients to watch for the sudden development of compulsive and addictive behaviors.

Howard Weiss of Sinai Hospital in Baltimore and Gregory Pontone of the Department of Neurological Sciences at Johns Hopkins University, write that “physicians have overestimated the benefits and underestimated the risks” of these drugs, which “should be used less frequently.”

The study’s authors are even calling for specific medications – two sold as Requip and Mirapex – to include Black Box warnings on their labels, the strongest form of product labels.

Parkinson’s Drugs and their Effects

Parkinson’s disease is the result of the loss of brain cells that produce dopamine, which the body uses to regulate motor skills. Two of the most popular Parkinson’s medications – Requip and Mirapex – belong to a class of drugs known as dopamine receptor agonists and are distributed to more than 30 percent of Parkinson’s patients.

While Parkinson’s drugs like Requip and Mirapex are effective at controlling symptoms, they are also associated with impulse control disorders. That’s because the drugs also dump dopamine into the pleasure and reward center of the brain.

Creating Dangerously Negative Behaviors

Scientists at the Mayo Clinic studied 11 patients between 2002 and 2004 who had developed a compulsion to gamble. All 11 patients were being treated with drugs to help with movement disorders.

Maryellen Dodd, the Mayo Clinic psychiatrist who led the research said that the patients reported compulsive gambling as “uncharacteristic of their baseline behavior. Nearly all the patients who came to our attention had never gambled or gambled very infrequently.”

All 11 patients were taking a dopamine agonist drug; nine reported the drug as Mirapex and the other two were taking prescribed Requip.

Of the 11, seven patients displayed habitual gambling behaviors within one to three months of beginning treatment. The other four began exhibiting compulsive gambling behaviors between 12 and 30 months of the start of medication.

In addition, at least six patients developed other impulse control disorders, include compulsive eating, hypersexuality and increased alcohol use. One patient became obsessed with pornography and engaged in extramarital affairs.

The Official Position

The National Parkinson’s Foundation says between 15 percent and 18 percent of all patients develop an impulse control disorder. They are currently urging authorities to show “strong consideration” before requiring a mandatory Black Box warning be placed on medication package labels.

The National Parkinson’s Foundation says between 15 percent and 18 percent of all patients develop an impulse control disorder.

“It’s a tricky question. We don’t them to be restricted,” says Michael Okun, national medical director. “We would be for labeling if it did not affect availability, but, if, in some way, labeling affects availability, we would be against” such a warning.

Learn more about behavorial disorders and how they are treated.