title: Impulse control disorder in a patient on long-term treatment with bromocriptine for a macroprolactinoma.
abstract: Impulse control disorders (ICDs) constitute socially disruptive behaviors such as pathological gambling, impulsive eating, compulsive shopping, and hypersexuality. These conditions are well recognized in patients on dopamine agonist (DA) therapy for Parkinson disease. Dopamine agonists are widely used as first-line agents in the treatment of prolactinomas, but ICDs in this group of patients are relatively rare, perhaps because of lower therapeutic doses used. A review of the literature yielded only a few cases of ICDs in patients on DA treatment for prolactinomas. These symptoms are perhaps underreported because of lack of awareness among patients and health care professionals. Impulse control disorders are recognized psychiatric disorders that have significant psychological and social implications, and patients need to be counselled about this rare possibility when embarking on prolonged DA therapy. We describe a young patient with severe, socially disruptive impulsivity manifesting with pathological gambling who had been on long-term bromocriptine therapy for a macroprolactinoma.
authors.affiliation: *Department of Endocrinology, University Hospital Aintree, Liverpool, England; and †Department of Neurology and Neuropsychiatry, and ‡Department of Neurosurgery, The Walton Centre for Neurology & Neurosurgery, Liverpool, England.
authors.forename: Sravan Kumar
authors.initials: SK
authors.lastname: Thondam
authors.forename: Sundus
authors.initials: S
authors.lastname: Alusi
authors.forename: Kieran
authors.initials: K
authors.lastname: O'Driscoll
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Gilkes
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cuthbertson
authors.forename: Christina
authors.initials: C
authors.lastname: Daousi
mesh_terms: D000328:Adult; D001971:Bromocriptine / Q000009:adverse effects* / Q000627:therapeutic use; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000150:complications; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015175:Prolactinoma / Q000150:complications / Q000188:drug therapy*
chemical_list: D018491:Dopamine Agonists; D001971:Bromocriptine