Impulse control disorders associated with dopaminergic drugs: A disproportionality analysis using vigibase

Area of Science:

• Pharmacovigilance
• Neuroscience
• Psychiatry

Background:

• Dopamine receptor agonists, used for Parkinson's disease (PD), are known to elevate the risk of impulse control disorders (ICDs).
• The potential for other dopaminergic drugs to increase ICD risk remains largely uninvestigated.
• This study aimed to assess the association between dopaminergic drug properties and the reporting of ICDs.

Purpose of the Study:

• To evaluate the disproportionality of reported impulse control disorders (ICDs) associated with dopaminergic drugs compared to non-dopaminergic medications.
• To identify specific drug classes and individual agents with a higher risk of inducing ICDs.
• To inform clinical practice regarding the safe prescription of dopaminergic agents.

Main Methods:

• A case/non-case disproportionality analysis was conducted using VigiBase data from 1968 to 2020.
• Cases comprised 852 reports of ICDs as suspected adverse drug reactions (ADRs).
• Non-cases included 281,720 reports of ADRs other than ICDs, with adjusted reporting odds ratios (aRORs) calculated.

Main Results:

• All investigated dopaminergic drugs showed a significantly higher reporting disproportionality for ICDs (aROR 20.4) compared to non-dopaminergic drugs.
• Primary dopaminergic agents for PD exhibited the highest disproportionality (aROR 52.1), followed by ADHD psychostimulants (aROR 5.8) and antidepressants (aROR 3.9).
• Pramipexole and ropinirole demonstrated the most pronounced reporting disproportionality for ICDs.

Conclusions:

• A clear signal of increased ICD occurrence exists for all studied dopaminergic drugs.
• Clinicians must counsel patients on the risk of ICDs and implement monitoring protocols when prescribing dopaminergic medications.
• Further research may explore the mechanisms underlying dopaminergic drug-induced ICDs.