DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Compulsive gambling as a side effect of a Parkinson’s drug

WOW! This is a new one for me. Study Links Parkinson’s Drug to Gambling

oe Neglia was a retired government intelligence worker with Parkinson’s disease when he suddenly developed what he calls a gambling habit from hell. After losing thousands of dollars playing slot machines near his California home several times a day for nearly two years, Neglia stumbled across an Internet report linking a popular Parkinson’s drug he used with compulsive gambling.

“I thought, ‘Oh my God, this must be it,’” he said. Three days after stopping the drug, Mirapex, “all desire to gamble just went away completely. I felt like I had my brain back.”

A Mayo Clinic study published Monday in July’s Archives of Neurology describes 11 other Parkinson’s patients who developed the unusual problem while taking Mirapex or similar drugs between 2002 and 2004. Doctors have since identified 14 additional Mayo patients with the problem, said lead author Dr. M. Leann Dodd, a Mayo psychiatrist.

“It’s certainly enough for us to be cautious as we are using it,” Dodd said. “We wouldn’t want them to have some kind of financial ruin or difficulties that could be prevented.”

Dr. Leo Verhagen, a Parkinson’s specialist at Chicago’s Rush University Medical Center who was not involved in the study, says he and some colleagues all have a few patients who developed compulsive gambling while taking Mirapex, a drug that relieves tremors and stiffness. The behavior usually disappears when the drug dose is lowered, Verhagen said. He praised the Mayo article for raising awareness for doctors and patients.

This article interests me for 2 reasons. First, the fact that a drug could stimulate compulsive gambling is amazing. This may help researchers understand the phenomenon of compulsive gambling. Second, having a drug model for compulsive gambling could help us develop drug therapy for these unfortunate people.

As my career progresses, I become more convinced that we really do not understand neurochemistry. Phenomena like this one may help us navigate through those waters. Finally, I hope that this rant will help a physician or a patient. As a physician I must keep this side effect in mind.

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