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Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies.
Parkinsonism Relat Disord. 2011 May; 17(4):260-4.PR

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.

Authors+Show Affiliations

Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. hassan.anhar@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21310646

Citation

Hassan, A, et al. "Dopamine Agonist-triggered Pathological Behaviors: Surveillance in the PD Clinic Reveals High Frequencies." Parkinsonism & Related Disorders, vol. 17, no. 4, 2011, pp. 260-4.
Hassan A, Bower JH, Kumar N, et al. Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies. Parkinsonism Relat Disord. 2011;17(4):260-4.
Hassan, A., Bower, J. H., Kumar, N., Matsumoto, J. Y., Fealey, R. D., Josephs, K. A., & Ahlskog, J. E. (2011). Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies. Parkinsonism & Related Disorders, 17(4), 260-4. https://doi.org/10.1016/j.parkreldis.2011.01.009
Hassan A, et al. Dopamine Agonist-triggered Pathological Behaviors: Surveillance in the PD Clinic Reveals High Frequencies. Parkinsonism Relat Disord. 2011;17(4):260-4. PubMed PMID: 21310646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies. AU - Hassan,A, AU - Bower,J H, AU - Kumar,N, AU - Matsumoto,J Y, AU - Fealey,R D, AU - Josephs,K A, AU - Ahlskog,J E, Y1 - 2011/02/09/ PY - 2010/11/04/received PY - 2011/01/12/revised PY - 2011/01/14/accepted PY - 2011/2/12/entrez PY - 2011/2/12/pubmed PY - 2011/10/11/medline SP - 260 EP - 4 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 17 IS - 4 N2 - 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. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/21310646/Dopamine_agonist_triggered_pathological_behaviors:_surveillance_in_the_PD_clinic_reveals_high_frequencies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(11)00012-5 DB - PRIME DP - Unbound Medicine ER -