Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies.
Parkinsonism Relat Disord
; 17(4): 260-4, 2011 May.
Article
em En
| MEDLINE
| ID: mdl-21310646
ABSTRACT
BACKGROUND:
Compulsive behaviors provoked by dopamine agonists often go undetected in clinical series, especially if not specifically inquired about.AIM:
To determine the frequency of compulsive behaviors in a Parkinson's disease (PD) clinic where agonist-treated patients were routinely asked about such aberrant behaviors.METHODS:
We utilized the Mayo Health Science Research database to ascertain all PD patients taking a dopamine agonist over a two year period (2007-2009). All were seen by a Mayo-Rochester Movement Disorders Staff specialist who routinely inquired about behavior compulsions.RESULTS:
Of 321 PD patients taking an agonist, 69 (22%) experienced compulsive behaviors, and 50/321 (16%) were pathologic. However, when the analysis was restricted to patients taking agonist doses that were at least minimally therapeutic, pathological behaviors were documented in 24%. The subtypes were gambling (25; 36%), hypersexuality (24; 35%), compulsive spending/shopping (18; 26%), binge eating (12; 17%), compulsive hobbying (8; 12%) and compulsive computer use (6; 9%). The vast majority of affected cases (94%) were concurrently taking carbidopa/levodopa. Among those with adequate followup, behaviors completely or partly resolved when the dopamine agonist dose was reduced or ceased.CONCLUSIONS:
Dopamine agonist treatment of PD carries a substantial risk of pathological behaviors. These occurred in 16% of agonist-treated patients; however, when assessing patients whose dose was at least minimally in the therapeutic range, the frequency jumped to 24%. Pathological gambling and hypersexuality were most common. Carbidopa/levodopa therapy taken concurrently with a dopamine agonist appeared to be an important risk factor.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Comportamento Compulsivo
/
Agonistas de Dopamina
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Antiparkinsonianos
Tipo de estudo:
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Aged
/
Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Parkinsonism Relat Disord
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos