MON-293 The Prevalence of Impulse Control Disorders in Patients with Acromegaly and Prolactinomas Treated with Dopamine Agonists

Abstract

Objective: There is emerging evidence linking dopamine agonist (DA) use with the development of impulse control disorders (ICD) in patients with prolactinomas. On the other hand, no data exist whether DA use in acromegaly is associated with ICD. We aimed to evaluate the prevalence of ICD, psychiatric symptoms in patients with prolactinoma and acromegaly receiving DA in comparison to those with nonfunctioning pituitary adenomas (NFA) and healthy controls (HC). Material and Method: Forty patients with prolactinoma, 40 patients with acromegaly, 38 patients with NFA and 32 HC were included in this study. All patients and controls included in the study were evaluated with revised version of Minnesota Impulsive Disorders Interview (MIDI-R), Symptom Check List (SCL-90-R) questionnaire, Barratt Impulsiveness Scale (BIS-11), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). All of the patients with prolactinoma and acromegaly had been receiving cabergoline therapy but patients with NFA had not been receiving cabergoline therapy at the time of the study. Results: We detected DA associated with ICD in 3 patients (7.5%) with prolactinoma, and 2 patients with acromegaly (5%). All patients’ symptoms resolved after either discontinuation of the drug or surgical intervention. There was no significant difference between patients with acromegaly and prolactinoma in terms of ICD prevalence. On the other hand, ICD was not detected in non functional adenoma and HC. There was no correlation between BIS-11 scores and total dose, mean monthly dose and duration of DA.According to SCL-90-R, obsession and interpersonal sensitivity positivity was significantly higher in patients with prolactinoma than acromegaly (p: 0.040, p:0.010, respectively). There was no significant difference between the groups in terms of BAI, BDI and BIS-11’s subscales and total scores (p> 0.005). Scl-90 somatization and depression positivity was significantly higher in patients with NFA than acromegaly (p: 0.043, p: 0.024 respectively). Likewise, scl-90 depression, interpersonal sensitivity and additional items subscale positivity was significantly higher in patients with NFA than HC (p: 0.005, p: 0.045, p: 0.045 respectively). Conclusion: Although DA dose was significantly higher in patients with acromegaly compared to patients with prolactinoma, there was no significant difference in the prevalence of DA -related ICD. We have showed that there was no association between BIS-11 scores and total DA dose, mean monthly DA dose and duration of DA treatment. The higher prevalence of depression, interpersonal sensitivity in patients with NFA in comparison to HC supports the hypothesis the presence of a pituitary adenoma per se might cause a large psychiatric symptom burden.