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Impulse control disorders arising in 3 patients treated with rotigotine
Thomas S Wingo1, Marian Evatt, Burton Scott
1Emory University School of Medicine, Atlanta, GA, USA.
Clinical Neuropharmacology
|November 4, 2008
Summary
Rotigotine, a dopamine agonist used for Parkinson disease, may cause impulse control disorders (ICDs) such as hypersexuality and pathological gambling. Reducing or stopping rotigotine effectively treated these ICDs in three patients.
Area of Science:
- Neurology
- Pharmacology
Background:
- Parkinson disease (PD) management often involves dopamine agonists.
- Rotigotine is a novel dopamine agonist used for PD treatment.
Observation:
- Three PD patients developed impulse control disorders (ICDs) while treated with rotigotine.
- ICD symptoms included hypersexuality, punding, and pathological gambling.
- Symptom onset occurred 4-8 years after PD diagnosis, concurrently with rotigotine and levodopa therapy.
Findings:
- Temporal association noted between rotigotine dosage increases and ICD development.
- Pre-existing behavioral tendencies (gambling, cross-dressing) may predispose individuals to ICDs.
- Reduction or discontinuation of rotigotine effectively managed ICD symptoms.
Implications:
- Rotigotine, like other dopamine agonists, carries a risk of inducing ICDs.
- Clinicians should monitor PD patients for ICDs during rotigotine therapy.
- Further research is warranted to understand the mechanisms and risk factors for rotigotine-induced ICDs.
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