title: Impulse control disorder in patients with Parkinson's disease under dopamine agonist therapy: a multicentre study.
abstract: BACKGROUND
  Impulse control disorders (ICDs) encompass a wide spectrum of abnormal behaviour frequently found in cases of Parkinson's disease (PD) treated with dopamine agonists (DAs). The main aim of this study was to analyse ICD prevalence with different DAs.
  
  
  METHODS
  We carried out a multicentre transversal study to evaluate the presence of ICDs in patients with PD chronically treated (>6 months) with a single non-ergolinic DA (pramipexole, ropinirole, or rotigotine). Clinical assessment of ICD was performed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease.
  
  
  RESULTS
  Thirty-nine per cent of patients (91/233) fulfilled the clinical criteria for ICD. The group of patients with ICD symptoms (ICD+) differed from those without ICD symptoms (ICD-) in younger age and type of DA intake. Oral DA treatment (pramipexole and ropinirole) was associated with higher risk of ICDs compared with transdermal DA (rotigotine): 84/197 (42%) patients treated with oral DA developed ICD, versus 7/36 (19%) patients treated with transdermal DA (Fisher's exact text <0.01). In univariate analysis, a younger age (p<0.01), treatment with rasagiline (p<0.05), and especially treatment with an oral DA (pramipexole or ropinirole) (p<0.01) were significantly associated with ICD. Multivariate analysis confirmed that oral DA remained significantly associated with ICD (p: 0.014, OR: 3.14; 1.26-7.83).
  
  
  CONCLUSIONS
  ICD was significantly associated with the use of the non-ergolinic oral DA (pramipexole and ropinirole) when compared with transdermal non-ergolinic DA (rotigotine). Since pramipexole, ropinirole and rotigotine are non-ergolinic DAs with very similar pharmacodynamic profiles, it is likely that other factors including route of administration (transdermal vs oral) explain the difference in risk of ICD development.
authors.affiliation: Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Garcia-Ruiz
authors.affiliation: Department of Neurology, IRYCIS, Hospital Ramon y Cajal, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martinez Castrillo
authors.affiliation: Department of Neurology, IRYCIS, Hospital Ramon y Cajal, Madrid, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Alonso-Canovas
authors.affiliation: Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Herranz Barcenas
authors.affiliation: Department of Neurology, Hospital Fundacion Alcorcon, Madrid, Spain.
authors.forename: Lydia
authors.initials: L
authors.lastname: Vela
authors.affiliation: Department of Neurology, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: Pilar
authors.identifier: http://orcid.org/0000-0003-0496-4767
authors.initials: P
authors.lastname: Sanchez Alonso
authors.affiliation: Department of Neurology, Hospital Infanta Sofia, Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Mata
authors.affiliation: Department of Neurology, Hospital Gomez Ulla, Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Olmedilla Gonzalez
authors.affiliation: Department of Epidemiology-Statistics, Fundacion Jimenez Diaz, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahillo Fernandez
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D052160:Benzothiazoles / Q000009:adverse effects / Q000627:therapeutic use; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000523:psychology*; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D000077487:Pramipexole; D012737:Sex Factors; D013764:Tetrahydronaphthalenes / Q000009:adverse effects / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000978:Antiparkinson Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D007211:Indoles; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C046649:ropinirole; D007980:Levodopa; D000077487:Pramipexole; C047508:rotigotine
keywords: Parkinson's Disease