Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary...

We aimed to assess the prevalence of impulse control disorders (ICDs) in patients with prolactin-secreting adenomas treated with dopamine agonists (DAs), to identify associated factors and to compare it with a group of patients with nonfunctioning pituitary adenoma.

In a postal survey, 77 patients from Group A (patients with prolactinomas and present or past use of DAs) and 70 patients from Group B (patients with nonfunctioning pituitary adenoma and no history of DA therapy) responded to a questionnaire on compulsive shopping, pathologic gambling, hypersexuality and punding. Associated clinical information was obtained through the survey and review of medical electronic records.

The total ICD prevalence was 24·68% in Group A and 17·1% in Group B (P = 0·31). Group A had an increased rate of hypersexuality (P = 0·03). Subgroup analysis revealed that men in Group A had a significantly increased frequency of total ICDs when compared with men in Group B (27·7 vs 3·7%, P = 0·01). No differences in rates of total ICDs were found between women of Groups A and B (20 vs 25·6%, P = 0·78). No association with type, dose or duration of treatment with DA was noted.

Males with prolactinomas treated with DAs were 9·9 times more likely to develop an ICD than their counterparts with nonfunctioning pituitary adenomas. Until prospective studies on the relationship of DA use in patients with prolactinoma and ICDs are available, the authors propose that patients with prolactinoma be forewarned of possible ICD development with DA therapy.