Compulsive Behaviors Are Common from Parkinson Treatment

People treated for Parkinson disease are prone to pathologic gambling, hypersexuality, and compulsive shopping, according to research that will be presented at the American Academy of Neurology 58th Annual Meeting in San Diego, Calif., April 1 - 8, 2006.

Reports have been growing in the past several years of compulsive behavior among patients with Parkinson disease who receive levodopa or dopamine agonists, the mainstays of Parkinson treatment. To examine the true extent of the problem, Valerie Voon, MD, of the National Institute for Neurologic Diseases and Stroke in Bethesda, MD, and her colleagues, conducted a prospective survey in almost 300 Parkinson patients, asking about pathologic gambling, hypersexuality, and compulsive shopping. They followed up with in-depth psychiatric interviews for those reporting any of the three compulsive behaviors.

Among their sample, pathologic gambling started in 10 patients (3.4 percent) after they began treatment, which is double the number expected based on population-wide surveys. These patients had lost an average of $150,000. Hypersexuality was seen in seven patients, and compulsive shopping in two.

The researchers examined the medications patients were taking to see if these influenced risk for compulsive behavior. They found that almost all patients who developed these behaviors were receiving both levodopa and a dopamine agonist. Patients on levodopa alone were much less likely to develop a compulsive behavior. No single dopamine agonist was more likely than another to be associated with these behaviors. One or another form of compulsive behavior was seen in 6 percent of the entire patient population, and 16 percent of those receiving both types of medication.

Voon cautions that these results must be interpreted with care, since the patients were drawn from a large specialty care center, and may not be representative of the Parkinson population as a whole. “Larger multi-center trials are required to definitively determine the differences between Parkinson patients and the general population,” Voon said. “Nonetheless, patients and caregivers should be aware of these commonly hidden behaviors.”

The American Academy of Neurology, an association of more than 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer disease, epilepsy, multiple sclerosis, Parkinson disease, and stroke.

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