title: Opioid antagonist naltrexone for the treatment of pathological gambling in Parkinson disease.
abstract: Pathological gambling (PG) is a potential complication related to the treatment of Parkinson disease (PD) with dopamine agonists (DA). The cause of this disorder is unknown, but altered dopamine neurotransmission may be involved.
  
  
  OBJECTIVE
  We evaluated the efficacy and tolerability of the opioid antagonist naltrexone in the treatment of PG in PD.
  
  
  METHODS
  Our cases included 3 patients with PD who developed PG after DA treatment.
  
  
  RESULTS
  Pathological gambling did not improve after reduction or discontinuation of DA. These patients responded poorly to serotonin reuptake inhibitors, whereas treatment with opioid antagonist naltrexone resulted in the remission of PG. Naltrexone treatment was well tolerated. In one patient, higher dose of naltrexone resulted in hepatic abnormalities, which resolved after dosage reduction.
  
  
  CONCLUSIONS
  The opioid antagonist naltrexone could be an effective option for the treatment of PG in PD.
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, SE-75185 Uppsala, Sweden. dag.nyholm@neuro.uu.se
authors.forename: Domenico
authors.initials: D
authors.lastname: Bosco
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Plastino
authors.forename: Carmela
authors.initials: C
authors.lastname: Colica
authors.forename: Francesca
authors.initials: F
authors.lastname: Bosco
authors.forename: Spanò
authors.initials: S
authors.lastname: Arianna
authors.forename: Antonino
authors.initials: A
authors.lastname: Vecchio
authors.forename: Francesco
authors.initials: F
authors.lastname: Galati
authors.forename: Dario
authors.initials: D
authors.lastname: Cristiano
authors.forename: Arturo
authors.initials: A
authors.lastname: Consoli
authors.forename: Domenico
authors.initials: D
authors.lastname: Consoli
mesh_terms: D000328:Adult; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use; D005715:Gambling / Q000139:chemically induced / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018491:Dopamine Agonists; D009292:Narcotic Antagonists; D009271:Naltrexone