Neurol. praxi. 2009;10(2):107-110

Pathological gambling in patients with Parkinson‘s disease

MUDr. Tomáš Gescheidt¹, doc. MUDr. Martin Bareš Ph.D²

¹ Centrum pro abnormální pohyby a parkinsonismus, I. neurologická klinika LF MU, FN u sv. Anny, Brno

² I. neurologická klinika LF MU a FN u sv. Anny Brno

The clinical presentation of Parkinson‘s disease (PD) is hallmarked by motor symptoms. In recent years, however, increasing attention has

been paid to nonmotor symptoms including sensory, vegetative, or mental symptoms. Since 2000, individual case reports have emerged

describing patients with PD who newly developed pathological gambling (PG) that subsided following a decreased dose of dopaminergic

medication. The retrospective or cross-sectional epidemiological studies available suggest a higher prevalence of PG (but also of other

conduct disorders such as pathological shopping, overeating, hypersexuality, or pathological stereotypy) in PD patients compared

to the general population. PG is particularly associated with dopamine agonist therapy (however, no differences have been found among

individual drugs of this group; likewise, a drug-dose dependence has not been unequivocally confirmed); additional risk factors mainly

include onset of disease at a younger age, personal or family history of alcohol abuse, or tendency to impulsive behaviour. Currently,

there are no general guidelines for prevention or therapeutic measures concerning PG in PD patients; it is considered appropriate

to make the patients aware of the risk of developing PG and to ask them about their symptoms regularly so that a potential problem could

be identified early. In individual cases, lowering the dose and/or changing the dopaminergic agonist may have beneficial effects.

Keywords: Parkinson‘s disease, pathological gambling, impulse control disorders, L-DOPA, dopaminergic agonists.

Published: May 1, 2009  Show citation