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Outcomes of Patients with Parkinson Disease and Pathological Gambling

Published online by Cambridge University Press:  02 December 2014

A. Bharmal ,
C. Lu ,
J. Quickfall ,
D. Crockford  and
O. Suchowersky
A. Bharmal
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
C. Lu
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
J. Quickfall
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
D. Crockford
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada Foothills Hospital Addiction Centre, University of Calgary, Calgary, Alberta, Canada
O. Suchowersky*
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Department of Medical Genetics, University of Calgary, Calgary, Alberta, Canada
*
Department of Medical Genetics, Area 3, UCMC, 3350 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
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Abstract

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Objective:

To determine the outcomes of patients with Parkinson disease (PD) with pathological gambling (PG) from one Canadian Movement Disorders Clinic.

Methods:

Assessments were performed in-person during routine clinic visits of all patients currently followed by one neurologist (OS). Pathological gambling was defined according to DSM-IV-TR criteria. Chart review was performed to obtain details on medication use, dosages, and patient demographics. Follow-up of patients with PG collected information on gambling behavior, PG management interventions, medications, treatment, and psychosocial outcomes.

Results:

146 patients were surveyed with an overall prevalence of PG of 4.1% (6/146). The rate of pathological gambling for those patients on dopamine agonist therapy (DA) was 8.1% (6/74). Only patients who were recreational gamblers prior to starting DA developed PG. All PG patients discontinued, decreased, or switched to another DA, and experienced a partial or full remission of PG. 3 (50%) patients described financial losses of $100,000 or more, and 75% (3/4) patients described significant marital stresses. At follow-up (August 2008), 4 of the 6 patients with PG continued to gamble in a controlled fashion despite medication changes. No significant difference in levodopa equivalent daily dose (LEDD) pre- and post-PG were observed; however, the relative amount of DA was decreased (p= 0.0593), while levodopa was relatively increased (p= 0.5277). Despite control of PG, patients still experience financial and marital strains.

Conclusions:

DA (in combination with levodopa) was associated with a significantly higher prevalence of PG in PD, particularly in patients who were recreational gamblers previously. Despite control of PG, patients continued to experience significant financial and marital stresses that should be regularly enquired upon in follow-up care and managed appropriately.

Information

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 4 , July 2010 , pp. 473 - 477
Copyright
Copyright © The Canadian Journal of Neurological 2010

References

1. Dodd, ML, Klos, KJ, Bower, JH, Geda, YE, Josephs, KA, Ahlskog, JE. Pathological gambling caused by drugs used to treat Parkinson Disease. Arch Neurol. 2005;62:1377–81.Google Scholar
2. Avanzi, M, Uber, E, Bonfa, F. Pathological gambling in two patients on dopamine replacement therapy for Parkinson’s Disease. Neurol Sci. 2004;25:98–101.Google Scholar
3. Molina, JA, Sainz-Artiga, MJ, Fraile, A, Jiménez-Jiménez, FJ, Villanueva, C, Ortí-Pareja, M, et al. Pathological gambling in Parkinson’s disease: a behavioral manifestation of pharmacologic treatment? Mov Disord. 2000;15(5):869–72.Google Scholar
4. Driver-Dunckley, E, Samanta, J, Stacy, M. Pathological gambling associated with dopamine agonist therapy in Parkinson’s disease. Neurology. 2003;61(3):422–3.Google Scholar
5. Gschwandtner, U, Aston, J, Renaud, S, Fuhr, P. Pathological gambling in patients with Parkinson’s Disease. Clin Neuropharm. 2001;24(3):170–2.Google Scholar
6. Voon, V, Hassan, K, Zurowski, M, de Souza, M, Thomsen, T, Fox, S, et al. Prospective prevalence of pathologic gambling and medication association in Parkinson disease. Neurology. 2006;66 (11):1750–2.Google Scholar
7. Avanzi, M, Baratti, M, Cabrini, S, Uber, E, Brighetti, G, Bonfa, F. Prevalence of pathological gambling in patients with Parkinson’s disease. Mov Disord. 2006;21(12):2068–72.Google Scholar
8. Weintraub, D, Siderowf, AD, Potenza, MN, Goveas, J, Morales, KH, Duda, JE, et al. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol. 2006;63(7):969–73.Google Scholar
9. Montastruc, JL, Schmitt, L, Bagheri, H. [Pathological gambling behavior in a patient with Parkinson’s disease treated with levodopa and bromocriptine]. Rev Neurol (Paris). 2003;159(4): 441–3. French.Google Scholar
10. Grosset, KA, Grosset, DG, Macphee, G, Pal, G, Stewart, D, Watt, A, et al. Problematic gambling on dopamine agonists: not such a rarity. Mov Disord. 2006;21(12):2206–8.Google Scholar
11. Crockford, D, Quickfall, J, Currie, S, Furtado, S, Suchowersky, O, El-Guebaly, N. Prevalence of problem and pathological gambling in Parkinson’s disease. J Gambl Stud. 2008;24(4):411–22.Google Scholar
12. Shaffer, HJ, Hall, MN, Vander Bilt, J. Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis. Am J Public Health. 1999;89(9):1369–76.Google Scholar
13. Volberg, RA. The prevalence and demographics of pathological gamblers: implications for public health. Am J Public Health. 1994;84(2):237–41.Google Scholar
14. Smith, GJ, Wynne, HJ. Measuring gambling and problem gambling in Alberta using the Canadian Problem Gambling Index (CPGI): Alberta Gambling Research Institute, 2002.Google Scholar
15. Association, AP. Diagnostic and statistical manual of mental disorders. 4th ed. Text revision ed. Washington, DC: American Psychiatric Association; 2003.Google Scholar
16. Shaw, MC, Forbush, KT, Schlinder, J, Rosenman, E, Black, DW. The effect of pathological gambling on families, marriages, and children. CNS Spectr. 2007;12(8):615–22.Google Scholar
17. Hodgins, DC, El-Guebaly, N. Retrospective and prospective reports of precipitants to relapse in pathological gambling. J Consult Clin Psychol. 2004;72:72–80.Google Scholar
18. Raylu, N, Oei, TPS. Pathological gambling: a comprehensive review. Clin Psychol Rev. 2002;22(7):1009–61.Google Scholar
19. Oei, TPS, Raylu, N. Psychosocial factors related to gambling abstinence and relapse in members of Gamblers Anonymous. J Gambl Stud. 2008;24:91–105.Google Scholar
20. Walker, MB. Treatment strategies for problem gambling: a review of effectiveness. In: Eadington, WR, Cornelius, JA, editors. Gambling behavior and problem gambling. Reno, Nevada: University of Nevada;1993 p. 533–66.Google Scholar
21. Kalivas, PW, Volkow, ND. The neural basis of addiction: a pathology of motivation and choice. Am J Psychiatry. 2005;162:1403–13.CrossRefGoogle ScholarPubMed
22. Nirenberg, MJ, Waters, C. Compulsive eating and weight gain related to dopamine agonist use. Mov Disord. 2006;21(4):524–9.Google Scholar
23. Klos, KJ, Bower, JH, Josephs, KA, Matsumoto, JY, Ahlskog, JE. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism Relat Disord. 2005;11(6):381–6.Google Scholar
24. Mamikonyan, E, Siderowf, AD, Duda, JE, Potenza, MN, Horn, S, Stern, MB, et al. Long-term follow-up of impulse control disorders in Parkinson’s disease. Mov Disord. 2008;23(1):75–80.Google Scholar
25. Lu, C, Bharmal, A, Suchowersky, O. Gambling and Parkinson disease. Arch Neurol. 2006;63:298.Google Scholar
26. Hughes, AJ, Daniel, SE, Kilford, L, Lees, AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181–4.Google Scholar
27. Hobson, DE, Lang, AE, Martin, WR, Razmy, A, Rivest, J, Fleming, J. Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group.[see comment]. JAMA. 2005;287:455–63.Google Scholar
28. Hodgins, DC, El-Guebaly, N. Natural and treatment-assisted recovery from gambling problems: a comparison of resolved and active gamblers. Addiction. 2000;95:777–89.Google Scholar
29. Echeburua, E, Baez, C, Fernandez-Montalvo, L. Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gambling: long-term outcome. Behav Cogn Psychotherapy. 1996;24(1):51–72.Google Scholar
30. Ledgerwood, DM, Petry, NM. What do we know about relapse in pathological gambling? Clin Psych Rev. 2006;26:216–28.Google Scholar
31. Lesieur, HR, Blume, SB. The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers. Am J Psych. 1987;144:1184–8.Google Scholar
32. Christenson, GA, Faber, RJ, deZwaan, M. Compulsive buying: descriptive characteristics and psychiatric comorbidity. J Clin Psych. 1994;55:5–11.Google Scholar