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Original Contribution: M. Leann Dodd; Kevin J. Klos; James H. Bower; Yonas E. Geda; Keith A. Josephs; J. Eric Ahlskog Pathological Gambling Caused by Drugs Used to Treat Parkinson Disease Arch Neurol 2005; 0: 62.9.noc50009-5 [Abstract] [Full text] [PDF]

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Electronic letters published:

Gambling behavior with Primazpexole as treatment for Restless Legs Syndrome

Steven R Brenner   (9 August 2005)

Gambling behavior with Primazpexole as treatment for Restless Legs Syndrome 9 August 2005
Steven R Brenner, MD Departments of Neurology at St. Louis Univ. and St. Louis VA Medical Center Send reply to journal: Re: Gambling behavior with Primazpexole as treatment for Restless Legs Syndrome SBren20979{at}aol.com Steven R Brenner	I read with interest the article relating to pathological gambling caused by the drug used to treat Parkinson's disease. I am acquainted with a similar circumstance arising in an older patient being treated with pramipexole for restless leg syndrome. He experienced the condition for about 15 years and due to worsening symptoms, pramipexole was prescribed about 10 years after onset. There was a good initial response; however, the dose was gradually increased from 0.125 mg in the evening initially due to recurrence of symptoms, until the dose stabilized at 1 mg daily, when symptoms were adequately controlled. The medication was continued for about 5 years with good control of restless legs symptoms. Recently, he sought medical advise after learning of patients experiencing pathological gambling related to medicines used to treat Parkinson's disease. He had been gambling, losing more money than he could afford, and was wondering if the medication could have contributed. Although he had gambled previously, it had been primarily recreational without creating any problems. Medications were changed due to the possibility of pramipexole contributing to gambling behavior. Pramipexole is commonly used as treatment for restless legs syndrome (1); however, there probably needs to be heightened awareness of potential adverse effects, such as pathological gambling and other compulsive behaviors. 1. Silber MH, Girish M, Izurieta R. Pramipexole in the management of restless legs syndrome: an extended study. Sleep. 2003;26:819-821.