Parkinson’s disease is a debilitating neurodegenerative disorder that affects thousands of people each year. A progressive disease, Parkinson’s develops slowly over a number of years, affecting the dopamine-producing parts of the brain. The resulting deficiency of dopamine is caused by loss of nerve cells within the brain.
Over the years, Parkinson’s has been treated through the use of medication to control the symptoms of impaired balance and motor problems. These medications are used to increase or substitute the low dopamine levels within the brain.
One type of medication is known as a dopamine agonist.
Dopamine Agonists for Parkinson's Disease
Dopamine agonists work to mimic dopamine effects within the brain and are effective in helping provide relief for symptoms. However, studies now show that dopamine agonists may contribute to impulse control disorders, such as gambling and compulsive behavior that can take the form of excessive shopping, sexual encounters or compulsive eating. Because dopamine is known as the “feel good” part of the brain, drugs that activate the dopamine receptors may create a risk for higher compulsive behavior.
Dopamine agonists can be taken on their own or with a medication known as levodopa, a highly effective medication used for Parkinson’s. Levodopa is a natural chemical that is converted to dopamine in the brain. Over the years, levodopa may lose its effectiveness and become less stable. Dopamine agonists are not as potent as levodopa and are often given in later stages of Parkinson’s, in conjunction with levodopa. Two of the most common types of dopamine agonists are Mirapex (pramipexole) and Requip (ropinirole).
Patients on dopamine agonists should be monitored by their doctor for any side effects or interactions with other medications. Interactions with alcohol, antipsychotics and blood pressure medications may lead to complications.
If the patient is suffering from compulsive behavior stemming from dopamine agonists, they may choose to try alternative treatment methods or a carbidopa-levodopa infusion. Some of the main issues that patients feel with Parkinson’s include motor problems - trouble walking, moving and with tremors. The need for medications can help to ease these symptoms. Significant improvements can take place in the early stages of Parkinson’s, but over time, the effects of medications may diminish, or may wax and wane over a period of time.
Impulse Control Disorders
According to a study published in the journal Neurology, 87 percent of participants who were diagnosed with Parkinson’s in the study reported that they had experienced impulse control disorders such as compulsive shopping, binge eating, compulsive sexual behavior, and gambling. During the study, 30 participants who were experiencing the disorder stopped taking the medication and found the symptoms had decreased. Dopamine agonists with the highest risk of increased impulsivity were Pramipexole and Ropinirole.
These drugs will work wonders for many coping with Parkinson’s disease, but for some the link between dopamine agonists and impulsive behavior is clear. Patients should be screened for compulsive behavior, consult with their physicians as to the best course of treatment, and be monitored over the course of time if they decide to take dopamine agonists.