Title

Pathological gambling caused by drugs used to treat Parkinson disease

Document Type

Article

Abstract

Background: Pathological gambling is a rare potential complication related to treatment of Parkinson disease (PD). However, the etiology of this behavior is poorly understood. Objective: To examine the relationship between medical therapy for PD and pathological gambling. Methods: In our routine movement disorders practice (2002-2004), we encountered 11 patients with idiopathic PD who had recently developed pathological gambling. We assessed the relationship to their medical therapy and compared them with cases identified by systematic review of the existing literature on pathological gambling and PD. Results: All 11 patients with PD and pathological gambling were taking therapeutic doses of a dopamine agonist; 3 of these patients were not treated with levodopa. In 7 patients, pathological gambling developed within 3 months of starting to take or escalating the dose of the agonist; in the other 4 with a longer latency, gambling resolved after the agonist use was discontinued. Pramipexole dihydrochloride was the agonist in 9 of 11 cases in our series and 10 of 17 in the literature (68% in total). Conclusions: Dopamine agonist therapy was associated with potentially reversible pathological gambling, and pramipexole was the medication predominantly implicated. This may relate to disproportionate stimulation of dopamine D3 receptors, which are primarily localized to the limbic system. ©2005 American Medical Association. All rights reserved.

Publication Date

9-1-2005

Publication Title

Archives of Neurology

ISSN

00039942

Volume

62

Issue

9

First Page

1377

Last Page

1381

PubMed ID

16009751

Digital Object Identifier (DOI)

10.1001/archneur.62.9.noc50009

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