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Impulse Control Disorders in Patients With Hyperprolactinemia on Dopamine Agonist Therapy-How Concerned Should We Be?
Ghazal Daftari1, Nicholas A Tritos1
1Neuroendocrine Unit and Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Summary
Dopamine agonists used for prolactinomas can cause impulse control disorders (ICDs) in 7.5% to 46% of patients. Early detection and management are crucial for patient well-being.
Area of Science:
- Endocrinology
- Neuroscience
- Psychiatry
Background:
- Dopamine agonists (DAs) like cabergoline and bromocriptine are primary treatments for prolactinomas.
- Impulse control disorders (ICDs) are an underrecognized adverse effect of DAs, manifesting as compulsive behaviors.
- ICDs can significantly impair patients' and families' quality of life.
Purpose of the Study:
- To review the prevalence, risk factors, pathophysiology, diagnosis, and management of ICDs in hyperprolactinemic patients on DAs.
Main Methods:
- A comprehensive electronic literature search was performed to identify relevant studies.
Main Results:
- The prevalence of ICDs in patients on DAs ranges from 7.5% to 46%, with cabergoline more frequently implicated.
- Risk factors include younger age, male sex, and genetic polymorphisms. Diagnostic tools are available for identification.
- Management may involve dose reduction, discontinuation of DAs, or psychiatric intervention.
Conclusions:
- ICDs are a significant concern in hyperprolactinemia treatment with DAs, necessitating awareness and management.
- Further research is required to understand risk factors, mechanisms, and optimal therapeutic strategies.
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