Pathological Gambling in Parkinson’s Disease: An Update on Medical Management

Domenico      Pirritano; Massimiliano      Plastino; Antonietta      Fava; Dario      Cristiano; Luca      Gallelli; Carmela      Colica; Domenico      Bosco

doi:10.2174/2211556011201040365

Abstract

Pathological Gambling (PG) is characterized by “the failure to resist gambling impulses despite severe personal, family or occupational consequences”. PG estimated prevalence ranges between 0.4% and 3.4% within the adult population. PG seems to be more common in patients with Parkinson’s disease (PD) than in the general population. In the past few years, PG has been reported as a side effect of dopamine agonist (DA) therapy used in PD. This association has aroused great interest for the dramatic impact PG has on patients’ quality of life. Management of PG in patients with PD could be demanding. It is based on patient and caregiver education, modification of dopamine replacement therapy, and in some cases psychoactive drug administration. This review describes possible pathogenesis of PG associated with DA therapy, available pharmacological treatments and management approaches that may increase the likelihood of satisfactory treatment outcomes in PD patients.

Keywords: Behavioural therapy, dopamine agonists, impulse control disorders, Parkinson’s disease, pathological gambling, pharmacological therapy, DA therapy, dopamine dysregulation syndrome, OC spectrum disorders, compulsive eating, Mood disorders , impulsivity, Non-ergot dopamine agonists, pharmacologic treatment, Parkinsonism