Abstract
IntroductionImpulse control disorders (ICDs) have been described as a side effect of dopamine agonists (DAs) in neurological as well as endocrine conditions. Few studies have evaluated the neuropsychological effect of DAs in hyperprolactinemic patients, and these have reported a relationship between DAs and ICDs. Our objective was to screen for ICD symptoms in individuals with DA-treated endocrine conditions.Materials and methodsA cross-sectional analysis was conducted on 132 patients with pituitary disorders treated with DAs (DA exposed), as well as 58 patients with pituitary disorders and no history of DA exposure (non-DA exposed). Participants responded to the full version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s disease (QUIP).ResultsCompared with the non-DA-exposed group, a higher prevalence of DA-exposed patients tested positive for symptoms of any ICD or related behavior (52% vs. 31%, p < 0.01), any ICD (46% vs. 24%, p < 0.01), any related behavior (31% vs. 17%, p < 0.05), compulsive sexual behavior (27% vs. 14%, p < 0.04), and punding (20% vs. 7%, p < 0.02) by QUIP. On univariate analysis, DA treatment was associated with a two- to threefold increased risk of any ICD or related behavior [odds ratio (OR) 2.43] and any ICD (OR 2.70). In a multivariate analysis, independent risk factors for any ICD or related behavior were DA use (adjusted OR 2.22) and age (adjusted OR 6.76). Male gender was predictive of the risk of hypersexuality (adjusted OR 3.82).DiscussionDespite the QUIP limitations, a clear sign of increased risk of ICDs emerges in individuals with DA-treated pituitary disorders. Our data contribute to the growing evidence of DA-induced ICDs in endocrine conditions.
Highlights
Impulse control disorders (ICDs) have been described as a side effect of dopamine agonists (DAs) in neurological as well as endocrine conditions
132 patients were affected by functional hyperprolactinemia or PRL, growth hormone (GH), or GH/PRLsecreting adenoma with present or past use of DAs, defined as DA exposed; cabergoline was the only DA employed in the study
This study revealed that DA treatment for endocrine conditions is associated with a higher risk of testing positive for ICDs by Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s disease (QUIP)
Summary
Impulse control disorders (ICDs) have been described as a side effect of dopamine agonists (DAs) in neurological as well as endocrine conditions. Impulse control disorders (ICDs) are psychopathological conditions characterized by difficulty resisting urges to engage in behaviors that are excessive and potentially harmful to oneself or others [1]. These disorders can cause significant impairment in social and occupational functioning, as well as legal and financial difficulties [1]. ICDs have been described as a side effect of treatment with dopamine agonists (DAs) since 2000, when the first cases of pathological gambling were reported in patients treated for Parkinson’s disease (PD) [3]. Pharmacological stimulation by DAs of the D3 dopamine receptors in the mesocorticolimbic dopaminergic pathway seems to be the mechanism underlying the activation of the reward system that leads to ICDs [6]
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