They noted that in seven patients, pathological gambling developed within one to three months of reaching the maintenance dose or with dose escalation of dopamine agonist treatment; none developed pathological gambling while treated with carbidopa/levodopa alone. The other four patients reported compulsive gambling 12 to 30 months after starting dopamine agonist therapy; excessive gambling abated in all four within months of discontinuing the agonist medication.
"When our neurologists tapered the patients off the medication, several reported a dramatic resolution of their problem," says Dr. Dodd. "One patient said it was 'like a light switch going off.'"
The researchers also learned that six of the Mayo Clinic patients developed additional behavioral issues which subsided when they quit the dopamine agonist medication, including compulsive eating with weight gain, increased alcohol consumption and hypersexuality (increased interest in pornography, extramarital affairs or increased sex drive bothersome to the spouse).
Dr. Ahlskog cites anecdotes of patients such as a seemingly responsible, married professional who had never gambled before, but began watching gambling shows on television and then gambling on the Internet from his work site after starting dopamine agonist treatment. He lost several thousand dollars. This behavior abruptly stopped within a few days of stopping the dopamine agonist drug. A clergyman sheepishly confided by phone after an office visit that he had an obsession with gambling, which started after beginning a dopamine agonist medication. Another patient lost over $100,000 as well as her first marriage due to her compulsive gambling. She could never
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