New onset heightened interest or drive for gambling,shopping,eating or sexual activity in patients with Parkinson's disease: the role of dopamine agonist treatment and age at motor symptoms onset

Abstract

Alterations of impulse control that have recently been associated with Parkinson's disease (PD) are serious behavioural disturbances with significant impact on PD patients and their families.

A total of 193 consecutive PD patients with no history of psychiatric illness and 190 age/gender-matched healthy controls were queried on the presence of new onset heightened interest or drive for gambling, shopping, eating or sexual activity (GSES). Clinical data were retrieved from medical charts and interviews. logistic regressions models assessed risk factors for these specific troublesome behaviours.

New or heightened interests or drives for GSES behaviours were reported by 27 patients (14% vs 0% for controls). Younger age at PD motor symptoms onset (OR = 0.99, p = 0.0172), male gender (OR = 1.10, p = 0.0576) and longer duration of treatment with dopamine agonists (DAs)(OR = 1.18, ≥6 years versus never treated, p = 0.0459) contributed additively to the risk of developing one or more of these behavioural features.

New onset heightened interests or drives for GSES are not rare behavioural disturbances among patients with PD. Age, gender and duration of treatment with DAs have an independent and additive effect on the risk to develop such behavioural changes. Patients should be informed about potential treatment-associated behavioural changes.

Keywords

Parkinson's disease gambling hypersexuality shopping bulimia dopamine agonist drugs impulse control disorder hedonic homeostatic dysregulation hypomania dopamine dysregulation syndrome

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