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Thursday, February 3, 2011

Dopamine Agonists and Compulsive Behaviors

It seems there has been an increase in news stories of late about  dopamine agonists (DA) and their side effects, particularly compulsive behaviors. Two such stories recently have featured men with PD who are now suing the makers of these drugs because they developed compulsive behaviors that lead to financial or other loss in their life.  Here is one of the stories out of Scotland:

PD drug and gambling addiction law suit

Though infrequent, I have seen a handful of families in clinic that have experienced some level of financial ruin due to compulsive spending or gambling after beginning a dopamine agonist. Our clinicians do a great job of counseling patients AND spouses about the risk for side effects associated with these drugs, but a handful of patients experience these very troubling compulsive behaviors anyway and often lack insight into their behaviors. These compulsive behaviors nearly always cause hardship, loss, and grief for the patient, the spouse, and their relationship. Our clinicians are careful to assess for the presence of these troubling side effects at follow-up appointments with both the patient and the spouse, but due to the nature of the compulsive behaviors (often secretive) these compulsive behaviors can go on for some time with detection by the spouse or provider.

What is the Social Worker's role in counseling patients and spouses about the risks of these drugs before they start taking them and as they are taking them?  How much should providers and Social Workers assess for the existence of these compulsive behaviors beyond discussion of the matter in clinic?  There is no doubt that many PD patients can get substantial relief from some of their PD symptoms with the use of these drugs. But the prevalence rate of the terrible side effects associated with the use of DAs seems to be high enough that it begs the question of weighing the risk vs. the reward in taking these medications. There are other side effects associated with these drugs that are more common than compulsive behaviors (fatigue) that are troubling to PD patients as well.

I would love to hear others' thoughts on this matter. Specifically: 

  • How much do your providers use these DAs in the treatment of PD?
  • What is the prevalence rate of the compulsive behaviors side effect in the use of DAs?  
  • How frequently do you see the terrible side effects of compulsive behaviors in the use of these drugs?  
  • And ultimately how can we as social workers intervene to assist families with this issue?



  1. This is probably one of the more challenging types of issues to deal with in this field. While I can't comment with certainty of numbers on the frequency of use of DA or the prevalence of side effects, my daily work experience can attest that we frequently are dealing with the terrible compulsive behaviors that can result. Often times these issues can be resolved with changes in medication and that is encouraging for patients and families.

    We certainly address potential side effects with all patients at their visits. Due to the sensitive nature of the topic, it sometimes is not raised during the visit, but might come out during a phone call with the nurse or SW. We strongly encourage patients to bring relatives for collateral information. We also provide contact info for the nurse and SW to the family and encourage them to call in confidence. We offer guidance when the problem arises, education and support as the meds are changing. It is most challenging when the patient lacks insight regarding the behavior and those patients without social support networks are at greater risk. Another way to educate and normalize these side effects such that patients and family member will disclose is to provide written matierial in the waiting room.

  2. PS I found your blog by doing an Internet search on the side effects of dopamine agonists as I am one of 100 people currently involved in a class action about these. The class action is against the drug companies who manufactured and promoted the drugs without comprehensive warnings about their side effects.

    Dopamine agonists have been used in the general treatment of movement disorders of which Parkinsons Disease is but one.

  3. My life was destroyed because of compulsive behaviour while taking this drug .No RISKS WERE NOT WORTH THE REWARD.I want to sue but wife doesnt want me to out of shame I guess .I nwas taking 10 mg of bromocriptine a day 70 mg a week but now am taking .05 milligrams twice a week.Went from 70 milligrams a week on one drug to 1 milligram of another and much better but damage is done.