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As a result, patients develop tremors, slowness of movement, rigidity in their arms and legs, and problems with their walking gait and balance, according to the Parkinson’s Foundation. Dopamine agonists help by directly stimulating the brain’s dopamine receptors, essentially acting as a stand-in for the neurotransmitter itself. Unfortunately, dopamine also is “centrally involved in the body’s reward system,” Boylan said. “Cocaine and nicotine produce a release of dopamine.” Doctors suspect that the activation of dopamine receptors by these drugs might fuel a person’s cravings, driving them to impulsive actions, she explained. In the study, French researchers found that 52% of Parkinson’s patients who ever used a dopamine agonist developed an impulse-control disorder over the course of five years, compared with only 12% of those who never used the drugs. The team, led by Dr Jean-Christophe Corvol, of the ICM Brain and Spine Institute at the Sorbonne University in Paris, identified impulse-control problems, such as binge-eating, sexual addiction, compulsive shopping and gambling. Other reported behaviours included intense focus on hobbies and creative pursuits, hoarding and wandering, Boylan said. “It may be coincidental, but bears mentioning that Robin Williams’ suicide took place shortly after initiation of an agonist,” Boylan wrote in an editorial accompanying the new study. The study authors noted that higher doses of the drugs or taking them for longer periods of time were associated with a greater risk of developing impulse-control problems. The drugs pramipexole (Mirapex) and ropinirole (Requip) appeared to carry the highest risk, the researchers said. Doctors treating patients using a dopamine agonist “should be extra vigilant, as impulse-control disorders in the setting of Parkinson’s disease could emerge after a significant delay,” Okun said.
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