Journal
CLINICAL NEUROPHARMACOLOGY
Volume 24, Issue 3, Pages 170-172Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00002826-200105000-00009
Keywords
Parkinson's disease; pathologic gambling; dopamine replacement therapy; dopaminergic reward system
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Patients with Parkinson's disease frequently have depression, anxiety, and obsessive-compulsive disorder. We observed two patients who had episodes of pathologic gambling. At the same time, their Parkinson's disease deteriorated and they initiated self-medication with dopaminergic drugs. In both patients, signs were present of an addiction to dopaminergic medication. Pathologic gambling ceased in these patients after a few months. The significance of an insufficient dopaminergic reward system in patients with stereotypical addictive-like behavior (e.g., pathologic gambling) is discussed in this report. The most likely explanation for this newly recognized behavioral disorder in patients with Parkinson's disease is enhanced novelty seeking as a consequence of overstimulation of mesolimbic dopamine receptors resulting from addiction to dopaminergic drugs.
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