Thondam Sravan Kumar, Alusi Sundus, O'Driscoll Kieran, Gilkes Catherine E, Cuthbertson Daniel J, Daousi Christina
*Department of Endocrinology, University Hospital Aintree, Liverpool, England; and †Department of Neurology and Neuropsychiatry, and ‡Department of Neurosurgery, The Walton Centre for Neurology & Neurosurgery, Liverpool, England.
Clin Neuropharmacol. 2013 Sep-Oct;36(5):170-2. doi: 10.1097/WNF.0b013e31829fc165.
Impulse control disorders (ICDs) constitute socially disruptive behaviors such as pathological gambling, impulsive eating, compulsive shopping, and hypersexuality. These conditions are well recognized in patients on dopamine agonist (DA) therapy for Parkinson disease. Dopamine agonists are widely used as first-line agents in the treatment of prolactinomas, but ICDs in this group of patients are relatively rare, perhaps because of lower therapeutic doses used. A review of the literature yielded only a few cases of ICDs in patients on DA treatment for prolactinomas. These symptoms are perhaps underreported because of lack of awareness among patients and health care professionals. Impulse control disorders are recognized psychiatric disorders that have significant psychological and social implications, and patients need to be counselled about this rare possibility when embarking on prolonged DA therapy. We describe a young patient with severe, socially disruptive impulsivity manifesting with pathological gambling who had been on long-term bromocriptine therapy for a macroprolactinoma.
冲动控制障碍（ICDs）构成了具有社会破坏性的行为，如病理性赌博、冲动性进食、强迫性购物和性欲亢进。在接受多巴胺激动剂（DA）治疗帕金森病的患者中，这些情况已得到充分认识。多巴胺激动剂被广泛用作治疗泌乳素瘤的一线药物，但这组患者中的冲动控制障碍相对少见，可能是因为使用的治疗剂量较低。对文献的回顾仅发现少数接受DA治疗泌乳素瘤的患者出现冲动控制障碍的病例。由于患者和医护人员缺乏认识，这些症状可能未得到充分报告。冲动控制障碍是公认的精神障碍，具有重大的心理和社会影响，在开始长期DA治疗时，需要向患者咨询这种罕见的可能性。我们描述了一名年轻患者，他患有严重的、具有社会破坏性的冲动行为，表现为病理性赌博，因巨大泌乳素瘤接受了长期溴隐亭治疗。
