Piribedil and Pathological Gambling in six Parkinsonian patients

Abstract

Impulse control disorders (ICD) in Parkinson's disease (PD) have attracted increasing interest. They are characterized by the inability to control the impulse to perform an act that can be detrimental to them or to others. Although dopamine agonists (DA), as a group, have been associated with impulse control disorders (ICD), piribedil has rarely been reported to cause them. Method Case reports of six parkinsonian patients on piribedil presenting pathological gambling (PG). Results All of the patients presented ICD associated with piribedil use. Two of them received this medication as first treatment and four of them who had developed ICDs secondary to other DA that reappeared with piribedil. Conclusion Despite piribedil is commercially available in only a few countries, it should be considered in the differential diagnosis of PG in patients with PD.

Piribedil for the Treatment of Motor and Non-motor Symptoms of Parkinson Disease

“…Case reports show that ICDs can occur with piribedil, as observed with other dopamine agonists [81][82][83]. In a recent survey conducted in 200 PD patients, we observed a nonsignificant increased risk of ICDs with piribedil (odds ratio [OR] = 2.18, 95 % confidence interval 0.56-8.53), which was lower than the risks observed with other agonists like ropinirole (OR = 6.05) or pramipexole (OR = 6.02) [84].…”

A Revision of the Relationship between Gambling Disorder, Attention Deficit Hyperactivity Disorder and Parkinson´s Disease

“…A study performed by Micheli's research group evaluated pd patients (n = 6) receiving piribedil (a dopamine agonist) and displaying gambling disorder and impulse control disorders (compulsive eating, hyper-sexuality, compulsive shopping; Micheli, Giugni, Espinosa, Calvo, & Raina, 2015). It concluded that piribedil should be considered in the differential diagnosis of gambling disorder in patients with pd.…”

“…For instance, treatment with dopaminergic drugs like Pramipexole -a partial/full D2/D3/D4 receptor agonist (Riba et al, 2008), Piribedil -a D2/D3 receptor agonist and D4 receptor antagonist (Micheli et al, 2015), Aripiprazole -a D2/D3/D4 receptor partial agonist (Gaboriau et al, 2014), and higher dosages of anti-Parkinsonian drugs (levodopa, dopamine equivalents or levodopa equivalents; Pontieri et al, 2015) have shown relatedness to gambling disorder in pd patients. On the other hand, dopamine related treatments like high dosages of anti-Parkinsonian drugs (levodopa, dopamine equivalents, levodopa equivalents; Pontieri et al, 2015), levodopa or dopamine agonists (Weintraub et al, 2010), type B monoamine oxidase inhibitors (Pérez-Lloret et al, 2012), increase the incidence of other impulse control disorders in pd patients based on different studies.…”