Association of dopamine agonist use with impulse control disorders in Parkinson disease.
OBJECTIVE
To determine the frequency and correlates of impulse control disorders (ICDs) in Parkinson disease (PD).


METHODS
An unstructured screening interview for ICDs (compulsive gambling, buying, and sexual behavior) followed by a telephone-administered structured interview for screen-positive patients.


METHODS
Two university-affiliated movement disorders centers.


METHODS
A convenience sample of 272 patients with idiopathic PD who were screened for psychiatric complications.


METHODS
Presence of compulsive gambling, buying, or sexual behavior as assessed by the Minnesota Impulsive Disorders Interview.


RESULTS
Eighteen patients (6.6%) with PD met criteria for an ICD at some point during the course of PD, including 11 (4.0%) with an active ICD. Compulsive gambling and compulsive sexual behavior were equally common. In a multivariate model, treatment with a dopamine agonist (P = .01) and a history of ICD symptoms prior to PD onset (P = .02) predicted current ICD. There were no differences between the dopamine agonists in their association with ICDs (P = .21), and daily doses of dopamine agonists were higher in patients with an ICD than in dopamine agonist-treated patients without an ICD (P < .001).


CONCLUSIONS
Patients with PD treated with a dopamine agonist should be made aware of the risk of developing an ICD and monitored clinically. Because dopamine agonists are increasingly being used for other indications, future research should assess the dopamine agonist-associated risk for ICDs in other populations.
Weintraub
Daniel
D
Department of Psychiatry, University of Pennsylvania, and Parkinson's Disease Research, Education, and Clinical Center, USA.
Siderowf
Andrew D
AD
Potenza
Marc N
MN
Goveas
Joseph
J
Morales
Knashawn H
KH
Duda
John E
JE
Moberg
Paul J
PJ
Stern
Matthew B
MB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052160:Benzothiazoles; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000453:epidemiology; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005715:Gambling; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D010479:Pergolide / Q000008:administration & dosage / Q000009:adverse effects; D000077487:Pramipexole; D012307:Risk Factors; D012725:Sexual Behavior / Q000187:drug effects; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000453:epidemiology; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects*
D052160:Benzothiazoles; D018491:Dopamine Agonists; D007211:Indoles; D013844:Thiazoles; C046649:ropinirole; D010479:Pergolide; D000077487:Pramipexole