Impulse Control Issues with Parkinson's Agonist Drugs

Part 2 - Continuation of previous post - http://cmfalling.blogspot.com/2012/04/this-might-be-funnyif-it-happened-to.html

One of the topics,  Dr. Greg Pontone, MD - Director of the Movement Disorder Psychiatric Clinic, discussed with us was Impulse Control Behavior problems that can occur with the Agonist drugs.  (Mirapex & Requip are the 2 most popular agonist used as Parkinson's treatments).  These issues include impulse control behaviors such as compulsive behaviors, and addictions (often gambling, shopping, or sexual). One lady in the discussion group said she experienced the compulsive behavior of picking her moles.  (The Doctor said there is actually a name for it - and he pronounced it too.  Surprisingly, I did not write down such an important piece of information.  Sorry!!)

The Doctor said most people (85%) do not have any of these behavior issues with these drugs, but about 15% do.  The problems are real and serious when they occur and can ruin peoples lives.  He asked us to get this info out to anyone we know who has Parkinson's.  So here it is - to the best of my memory!!

The meds may start the problem, but going off the meds does not necessarily stop the problem.  The earlier the symptoms are reported to the doctor, the better!  Let me repeat that - THE EARLIER THE SYMPTOMS ARE REPORTED TO THE DOCTOR, THE BETTER!!!! 

Many will not report the problem to their doctors because they are embarrassed, they don't recognize they have a problem, or they think they can control it.   It is IMPORTANT that family members know about these possible side effects and watch for signs.  The earlier it is caught the easier it is to stop.   If it gets to the addiction stage, the person has to fight it like any normal person fights addiction - usually by enrolling in an addiction 12 step program. And like any addiction, they are hard to overcome - even after going off the meds that caused it.   If the behaviors are caught early before the full blown addiction stage, they can often be treated by just changing the meds. 

One interesting side note  - the Doctor said for those patients whose Parkinson's symptoms are responding really well to the agonist drug, but are experiencing the impulse control issues, they can sometimes keep them on the agonist by adding a drug like Naltrexone.  For some adding the Naltrexone will stop the compulsions and allow the person to still enjoy the Parkinson symptom control from the Agonist drug for awhile longer.

Disclaimer:  The above was written with the help of my very disorganized notes and faulty memory! However, I did run it by Hubby who also attended the session.  His response when I asked if it was accurate according to his memory:  "I don't remember - where's your notes?"  Oh well!  Please consult your doctor for more accurate info!   In other words - Don't quote me!!!!  ha ha