title: Pathologic gambling in patients with Parkinson's disease.
abstract: Patients with Parkinson's disease frequently have depression, anxiety, and obsessive-compulsive disorder. We observed two patients who had episodes of pathologic gambling. At the same time, their Parkinson's disease deteriorated and they initiated self-medication with dopaminergic drugs. In both patients, signs were present of an addiction to dopaminergic medication. Pathologic gambling ceased in these patients after a few months. The significance of an insufficient dopaminergic reward system in patients with stereotypical addictive-like behavior (e.g., pathologic gambling) is discussed in this report. The most likely explanation for this newly recognized behavioral disorder in patients with Parkinson's disease is enhanced novelty seeking as a consequence of overstimulation of mesolimbic dopamine receptors resulting from addiction to dopaminergic drugs.
authors.affiliation: Psychiatric Outpatient Department, University Hospital Basel, Basel, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Gschwandtner
authors.forename: J
authors.initials: J
authors.lastname: Aston
authors.forename: S
authors.initials: S
authors.lastname: Renaud
authors.forename: P
authors.initials: P
authors.lastname: Fuhr
mesh_terms: D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D005106:Exploratory Behavior; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D007980:Levodopa / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology*
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007980:Levodopa