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Rating L-DOPA-Induced Dyskinesias in the Unilaterally 6-OHDA-Lesioned Rat Model of Parkinson's Disease
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Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson's disease and

Kevin J Klos1, James H Bower, Keith A Josephs

  • 1Department of Neurology, Division of Movement Disorders, Mayo Clinic, Rochester, MN 55905, USA. kklos@tulsacoxmail.com

Parkinsonism & Related Disorders
|August 20, 2005
PubMed

Insights

Dopamine agonist therapy for Parkinson's disease (PD) and multiple system atrophy (MSA) can trigger pathological hypersexuality. This impulse control disorder often resolves upon medication withdrawal, even with continued levodopa treatment.

Area of Science:

  • Neurology
  • Neuroscience
  • Psychiatry

Background:

  • Dopamine agonist medications are frequently used to manage Parkinson's disease (PD) and multiple system atrophy (MSA).
  • Impulse control disorders, including pathological hypersexuality, have been anecdotally linked to dopaminergic therapies.

Observation:

  • This study observed pathological hypersexuality in 13 patients with PD and two with MSA.
  • In 14 of 15 cases, hypersexuality emerged within 8 months of initiating dopamine agonist therapy.
  • Four patients on monotherapy experienced hypersexuality, which resolved after discontinuing the agonist but not levodopa.

Findings:

  • Hypersexuality resolved in all four cases where dopamine agonists were stopped, irrespective of concurrent levodopa use.
  • In 60% of cases (9 patients), hypersexuality was accompanied by other compulsive or addictive behaviors.
  • A literature review indicated 90% of all reported cases (26 of 29) involved adjuvant dopamine agonists.

Implications:

  • Dopamine agonists may precipitate pathological hypersexuality and other impulse control disorders in susceptible individuals with PD and MSA.
  • Discontinuation of dopamine agonists should be considered in patients presenting with new-onset hypersexuality.
  • Further research is warranted to elucidate the neurobiological mechanisms underlying dopamine agonist-induced behavioral changes.

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