We received a few emails suggesting we follow up on this, so here it is.
Recent research -- and hard-knock experiences -- indicate that a lack of impulse control, such as pathological gambling and hypersexuality, is a possible side effect of drugs used to treat Parkinson’s Disease (PD) and Restless Legs Syndrome (RLS).
According to the Parkinson's Disease Foundation, "Recent studies suggest that seriously disabling impulsive behaviors occur in three to five percent of PD patients, affecting individuals at all stages of the disease."
The problem is difficult to quantify, since the pathologies are often played out in private or their connection to PD is so improbable that they’re not discussed with doctors. However, it’s been found that in almost all cases, "The impulsive behaviors ... are at odds with the person’s pre-Parkinson’s personality."
In addition, the impulse-control disorders (ICDs) are most serious among people who have advanced cases of PD (and take higher doses of PD medications). Thus, more and more evidence is emerging that either PD itself, or the drugs used to control it, either cause or contribute to ICDs.
The physiology involved is, of course, complex, but it involves the loss of dopamine caused by PD and its replacement by dopaminergic medications. Dopamine is used to restore muscle control in both PD and RLS patients, but it’s also involved in emotional responses and the ability to experience pleasure and pain.
The most common disorders in both PD and RLS patients who are being treated reportedly involve pathological gambling, hypersexuality, and compulsive shopping -- all pursuits the patient indulges in to the extreme in the effort to experience the sensations of pleasure and reward that they can no longer get from normal daily activities. Ironically, another of the top ICDs that PD patients experience is abuse of anti-Parkinson’s medication! Talk about a vicious cycle.
Men seem to be more prone to the side effects than women, and the younger PD occurs, the more likely a patient is to exhibit ICDs.
The Archives of Neurology published a report in 2005 that cited 11 Parkinson’s patients at the Mayo Clinic taking the drug Mirapex who developed ICDs, primarily gambling, shopping, and sex disorders. Following the study, another 14 patients were identified. Meanwhile, a California attorney claims to have spoken to 200 Mirapex users who developed compulsive behaviors; class-action lawsuits in the U.S. and Canada are under way.
Anecdotal evidence points to Mirapex as the culprit. An Associated Press report cited a California man who, while taking the drug, "developed a gambling habit from hell." After losing thousands of dollars playing slot machines at a nearby casino over a two-year period, he stumbled across a report linking the drug to compulsive gambling. Three days after stopping taking Mirapex, he said, "All desire to gamble went away completely."
No matter how you look at it, it is a strange and tragic development. Jessica Roe, Huntington Press Web-Content manager and Question of the Day supervisor, tells the following story.
"It was back in 2005, I believe, and I was making a documentary for the BBC about gambling addiction. The director and I were at a (controversial) gambling-addiction treatment center in Baltimore and one of the subjects we interviewed was a late-middle aged man, an ex-senior military career officer. He'd been in the Army all his life and his entire gambling experience had been limited to the odd friendly poker game with military buddies.
"He was with his wife of many decades, a strong, attractive, and long-suffering woman with a desperate look in her eyes (I doubt the marriage lasted, although she'd stuck by him up till then). A year or two prior to our meeting and just following his military retirement, he'd been diagnosed with Parkinson's disease. So for him it was a sort of double whammy: boredom and medication. He started receiving treatment and within the space of a few months (and I'm talking two or three -- what shocked me most was how fast it had happened), he'd blown their entire life savings and landed them up to their necks in debt.
"The cause? Foxwoods slot machines. They lived in Rhode Island, just across the border from Connecticut, but I don't think he'd ever been to a casino until he started on the meds. His wife had no idea what was going on until it was too late.
"The effects of the illness were very evident -- he was shaking like a leaf the whole time we were with him and was obviously a shadow of his former self. I don't recall if he was off the meds or not -- I think not -- but even if he was, the gambling demon had such a hold over him by that point that he’d still failed to kick it. Which is why they were at this place in Baltimore.
"I don't know the end of the story, but I'd put money on divorce and suicide being the final outcome. Tragic."
