![]() 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. 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. Methods In our routine movement disorders practice (2002-2004), we encountered 11 patients with idiopathic PD who had recently developed pathological gambling. Objective To examine the relationship between medical therapy for PD and pathological gambling. However, the etiology of this behavior is poorly understood. 2003 26:819-821.īackground Pathological gambling is a rare potential complication related to treatment of Parkinson disease (PD). Pramipexole in the management of restless legs syndrome: an extended study. Pramipexole is commonly used as treatment for restless legs syndrome (1) however, there probably needs to be heightened awareness of potential adverse effects, such as pathological gambling and other compulsive behaviors.ġ. Medications were changed due to the possibility of pramipexole contributing to gambling behavior. Although he had gambled previously, it had been primarily recreational without creating any problems. He had been gambling, losing more money than he could afford, and was wondering if the medication could have contributed. Recently, he sought medical advise after learning of patients experiencing pathological gambling related to medicines used to treat Parkinson's disease. The medication was continued for about 5 years with good control of restless legs symptoms. There was a good initial response however, the dose was gradually increased from 0.125 mg in the evening initially due to recurrence of symptoms, until the dose stabilized at 1 mg daily, when symptoms were adequately controlled. He experienced the condition for about 15 years and due to worsening symptoms, pramipexole was prescribed about 10 years after onset. I am acquainted with a similar circumstance arising in an older patient being treated with pramipexole for restless leg syndrome. I read with interest the article relating to pathological gambling caused by the drug used to treat Parkinson's disease. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Still, more well-controlled studies with control of comorbid psychiatric conditions are needed. Pharmacotherapy may yield beneficial effects in the treatment of pathological gamblers. Mood stabilisers gave improvement in the one placebo-controlled study as well as in both studies with a pre-post design. Opioid antagonists were associated with improvement in one placebo-controlled study and in one study with a pre-post design. ![]() Selective serotonin reuptake inhibitors and similar compounds were associated with improvement in two out of five placebo-controlled studies and in two out of three studies with a pre-post design. Studies for inclusion were identified through searches in PubMed covering the period 1950 to June 2005. Recently, however, several studies investigating the effects of pharmacological interventions have been published. The majority of treatment studies and available treatments today are based upon cognitive-behavioural therapy. The need for effective treatment for pathological gambling is urgent.
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