Impulse control disorders in patients with pituitary adenoma managed with or without dopamine agonists: a...

Studies from various countries raise concerns on the association between dopamine agonist (DA) treatment and impulse control disorders (ICDs) in patients with pituitary adenomas. We investigated the prevalence of ICDs in patients with pituitary adenomas in a UK centre using two instruments applied in clinical practice for assessing ICDs.

Cross-sectional study of adults with prolactinoma, acromegaly or non-functioning pituitary adenoma (NFPA) treated or not with DAs in a pituitary centre. Screening tools for ICD were the Minnesota Impulse Disorders Interview (MIDI) and Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale (QUIP-RS).

Data from 200 patients were analysed [72 prolactinomas (on DA), 71 NFPAs (no DA), 57 with acromegaly (12 on DA)]. The percentage of patients scoring for any ICD was higher in the prolactinoma on DA group compared with the NFPA cases; MIDI 12.7% vs. 1.4% (p = 0.02) and QUIP-RS 46.5% vs. 18.6% (p < 0.001), respectively. DA use was associated with positive scores for all ICDs in the MIDI and with compulsive buying and hobbyism-punding in the QUIP-RS. DA dose or treatment duration were not associated with positive scores. The responses of patients with acromegaly on DA did not differ from those not on these agents in any questionnaire.

In this sample of UK patients, prevalence of ICDs is higher in prolactinoma patients on DA compared to those with NFPA not on DA. Differences were not observed between patients with acromegaly treated or not with DA. Different ICD assessment tools have an impact on the detected outcomes.