Singh Asha, Kandimala Geetha, Dewey Richard B, O'Suilleabhain Padraig
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9036, USA.
J Clin Neurosci. 2007 Dec;14(12):1178-81. doi: 10.1016/j.jocn.2007.01.009. Epub 2007 Aug 27.
Three hundred patients with Parkinson's disease taking dopamine agonists were surveyed for the presence of compulsions. Fifty-eight reported active compulsions which had developed after initiation of dopamine agonists. These included 25 with sexual compulsions and 28 with self-described compulsive gambling, of whom 17 met criteria for pathologic gambling. Males were over-represented. Patients with any compulsion and those with pathologic gambling were about 6 years younger than those without compulsions. These behavioral problems were not associated with an individual dopamine agonist, nor dose or duration, nor concomitant levodopa. Follow-up of the pathologic gamblers 1 year after intervention, which was cessation of the dopamine agonist in most cases, found ongoing but controlled gambling in five and complete cessation within 4 months in the remainder.
对300名正在服用多巴胺激动剂的帕金森病患者进行了强迫行为调查。58名患者报告称在开始服用多巴胺激动剂后出现了主动强迫行为。其中包括25名有性强迫行为的患者和28名自述有强迫性赌博行为的患者,其中17名符合病态赌博的标准。男性占比过高。有任何强迫行为的患者和有病态赌博行为的患者比没有强迫行为的患者年轻约6岁。这些行为问题与特定的多巴胺激动剂、剂量、用药时长或左旋多巴的联合使用无关。对病态赌博患者在干预(大多数情况下为停用多巴胺激动剂)1年后进行随访发现,5名患者仍有持续但得到控制的赌博行为,其余患者在4个月内完全停止了赌博。