Jump to ContentJump to Main Navigation
Dementia with Lewy Body and Parkinson's Disease PatientsPatient, Family, and Clinician Working Together for Better Outcomes$
Users without a subscription are not able to see the full content.

J. Eric Ahlskog

Print publication date: 2013

Print ISBN-13: 9780199977567

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199977567.001.0001

Show Summary Details
Page of

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 24 October 2021

Pathologic Behaviors Provoked by Dopamine Agonist Drugs: Gambling, Sex, Eating, and Spending

Pathologic Behaviors Provoked by Dopamine Agonist Drugs: Gambling, Sex, Eating, and Spending

(p.117) 11 Pathologic Behaviors Provoked by Dopamine Agonist Drugs: Gambling, Sex, Eating, and Spending
Dementia with Lewy Body and Parkinson's Disease Patients

J. Eric Ahlskog

Oxford University Press

Dopamine agonists are synthetic medications that stimulate dopamine receptors. They are commonly used for treatment of Parkinson’s disease and in lower doses for restless legs syndrome. This drug class includes pramipexole (Mirapex), ropinirole (Requip), and the rotigotine patch (Neupro). These drugs have special properties, with unique adverse effects that are not intuitively associated with the drug. Hence, a brief chapter is devoted to these side effects. If the patient is not taking one of these medications, this chapter may be skipped. Several years ago clinicians recognized that pramipexole and ropinirole were associated with the development of pathologic gambling. Insidiously, a minority of people who were prescribed these medications began experiencing the desire to gamble, such as at casinos or online. For some, this was an exacerbation of prior tendencies, but for others this desire came out of the blue, with no prior gambling history. Other types of compulsive pathologic behaviors soon were also recognized in some people treated with these drugs. This included inappropriate hypersexual behavior (extramarital affairs, pornography) and compulsive spending, eating, drinking, or smoking. In many people, this behavior was completely out of character. The common element was the initiation of pramipexole or ropinirole. The behaviors did not develop immediately, but insidiously became apparent after the medication was slowly escalated into the therapeutic range. Patients and family were often oblivious to the behavior or relation to the drug until specifically asked about it in the doctor’s office. The common theme among these compulsive behaviors is that they are inherently rewarding human experiences. It became recognized that use of these dopamine agonist drugs by some people was associated with a pathologic drive to excessively engage in such activities as gambling, sex, eating, or spending. For affected people, this began to dominate their thoughts and actions. Who would think that a drug could drive specific hedonistic or rewarding behaviors? Experience in the clinic and published evidence, however, corroborates this risk. The two primary agents that have been implicated are pramipexole (Mirapex) and ropinirole (Requip). The rotigotine patch has also been associated with such behaviors, but apparently less frequently.

Keywords:   Neupro patch (rotigotine), gambling behaviors, hypersexual behavior, sexual ideation behavior, smoking compulsivity, spending behaviors

Oxford Scholarship Online requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter.

Please, subscribe or login to access full text content.

If you think you should have access to this title, please contact your librarian.

To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us .