title: Investigation of impulsivity in patients on dopamine agonist therapy for hyperprolactinemia: a pilot study.
abstract: The use of dopamine agonists (DAs) has been associated with increased impulsivity and impulse control disorders in several diseases, including Parkinson's disease. Such an effect of DAs on impulsivity has not been clearly characterized in hyperprolactinemic patients, where DAs are the mainstay of therapy. We studied the effects of DAs on impulsivity in hyperprolactinemic patients treated at a tertiary pituitary center, using validated psychometric tests. Cross-sectional study. Impulsivity was evaluated in 30 subjects, 10 hyperprolactinemic patients on DAs compared to two control groups; one comprising untreated hyperprolactinemic patients (n = 10) and a second group consisting of normoprolactinemic controls with pituitary lesions (n = 10). Measures of impulsivity included both self-report questionnaires as well as laboratory-based tasks. Hyperprolactinemic patients on DAs had a higher score (mean ± SD) in one self-report measure of impulsivity, the attention subscale of the Barratt Impulsiveness Scale (16.2 ± 2.7), as compared to the hyperprolactinemic control group (12.3 ± 2.5) and the normoprolactinemic group (14.7 ± 4.4) (p = 0.04). No statistically significant difference was found between groups with regards to the other impulsivity scales. In the DA-treated group, a correlation was observed between increased impulsivity (as assessed in the Experiential Discounting Task) and higher weekly cabergoline dose (r(2) = 0.49, p = 0.04). The use of DAs in hyperprolactinemic patients is associated with an increase in one aspect of impulsivity. This effect should be further characterized in larger, longitudinal studies.
authors.affiliation: Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 112, Boston, MA, 2114, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Barake
authors.forename: A Eden
authors.initials: AE
authors.lastname: Evins
authors.forename: Luke
authors.initials: L
authors.lastname: Stoeckel
authors.forename: Gladys N
authors.initials: GN
authors.lastname: Pachas
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Nachtigall
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
authors.forename: Beverly M K
authors.initials: BM
authors.lastname: Biller
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Tritos
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000328:Adult; D000368:Aged; D000077465:Cabergoline; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use*; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000188:drug therapy*; D007175:Impulsive Behavior / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011594:Psychometrics; D057566:Self Report; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline