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Pathologic Gambling Seen in RLS Patients Treated With Dopamine Agonists NEW YORK (Reuters Health) Jan 31 - Impulsive behavior sometimes seen with dopamine agonist therapy may affect patients other than those with Parkinson's disease. Patients with restless legs syndrome (RLS) who are treated with dopamine agonists may be at increased risk for pathologic gambling, according to a report in the January issue of Neurology. "A recent meta-analysis evaluating the available literature reported a lifetime prevalence of pathologic gambling in the general U.S. population of 1.93%," Dr. M. Tippmann-Peikert and colleagues from the Mayo Clinic College of Medicine, Rochester, Minnesota, write in the January issue of Neurology. "A similar or even higher frequency has been suggested in patients with Parkinson's disease (PD) treated with dopamine agonists." In the current study, the researchers report on three patients -- two middle-aged women and an older man -- with restless legs syndrome who developed pathologic gambling while being treated with dopamine agonists. None of the patients had signs of parkinsonism on neurologic examination, and none was aware of the reported link between dopamine agonists and pathologic gambling in PD patients. One of the patients had no gambling experience prior to dopamine agonist therapy, while two had minor pre-existing recreational gambling experience. At the time gambling commenced or worsened, the three patients were on a mean dose of pramipexole of 0.5 mg/day (range 0.125 to 0.75 mg). One patient was also on a daily dose of 0.25 mg of ropinirole. The behavior got worse with dose increments. The patients had been treated with the dopamine agonists for a mean of 9.3 months at the time of onset of gambling compulsions. The patients reported gambling losses of more than $750 in a year, $140,000, and "several hundred thousand dollars." Once dopamine agonist therapy was discontinued, pathologic gambling resolved or markedly decreased in all three patients. Two of the patients continued to gamble infrequently and without much financial loss. "Future studies are needed to establish if the prevalence of this condition in this population is different from that in the general population," Dr. Tippmann-Peikert and colleagues note. "However, the close time relationship of development or significant worsening of gambling behaviors in our patients as well as the resolution upon discontinuation of the dopaminergic agents suggest a causative association." Neurology 2007;68:301-303. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn