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Parkinson's Drugs Linked to Compulsive Behaviors
04.05.06, 12:00 AM ET
http://www.forbes.com/lifestyle/health/feeds/hscout/2006/04/05/hscout531977.html
WEDNESDAY, April 5 (HealthDay News) -- New research provides more evidence
that some Parkinson's drugs have rare and unusual side effects: They seem to
make patients oversexed and turn them into compulsive gamblers.
The behaviors appear in only a small percentage of Parkinson's patients, but
they're still more common than in ordinary people, a new study suggests. And
the side effects can be serious: 10 people who developed a gambling
compulsion after going on drugs such as levodopa lost an average of $150,000
each.
The compulsive behavior in patients who take the drugs "is treatable and
reversible, but people need to be aware of it," said study co-author Dr.
Valerie Voon, a research fellow at the National Institute of Neurological
Disorders and Stroke.
Researchers have known about links between Parkinson's drugs and compulsive
behavior since the 1970s when doctors noticed that some patients were
"hypersexual," Voon said. In 2005, a study reported on 11 Parkinson's
patients who became compulsive gamblers after taking drugs to treat the
disease; eight stopped the behavior after going off the medications.
In the new study, Voon and her colleagues surveyed 296 Parkinson's disease
patients, many of whom were in their 60s and had developed the illness in
their 50s.
The findings were to be presented Wednesday at the American Academy of
Neurology annual meeting, in San Diego.
The researchers found that 10 patients -- 3.4 percent -- showed signs of
compulsive gambling, about double the percentage seen in the general
population. Patients preferred slot machines, Voon said. The devices don't
"require as much cognitive process, and there's much more immediate gain as
opposed to playing poker or waiting for the lotto to come through," she
explained.
The researchers also found signs of oversexed behavior -- including excessive
use of Internet pornography and visits to prostitutes -- in seven patients
and compulsive shopping in two.
The patients who received two kinds of Parkinson's drugs -- levodopa and
dopamine agonists -- were more likely to suffer from the apparent side
effects. Sixteen percent of those who used both drugs showed signs of
compulsive behavior, compared to 6 percent of those who just used one.
The link between the drugs and the behavior isn't clear. "There's probably
some kind of underlying susceptibility," Voon said. "Whether it's an
individual [issue] or Parkinson's-related is a separate question."
One potential explanation lies in the actions of dopamine, a brain chemical
that sends a "reward" signal to the brain and assists with movement and
balance.
If they work properly, Parkinson's drugs adjust dopamine levels to help
patients fend the instability caused by the disease. But it's also possible
"that the dopamine reward system in the brain is stimulated by these drugs,"
leading to compulsive behavior, said Paul R. Sanberg, director of the
University of South Florida's Center of Excellence for Aging and Brain
Repair.
What to do? There's no reason for Parkinson's patients to panic, Voon said.
The side effects affect only a small proportion of patients, "and the
majority of people do fine."
Still, she said, there's reason to carefully monitor some patients, especially
those who have a history of alcoholism and are risk-takers. "If you see those
factors, it is possible that person may be more prone to developing these
behaviors. Following them carefully would make a lot of sense."
More information
For more on Parkinson's disease, visit the National Institute of Neurological
Disorders and Stroke.

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