Clinical reports, primarily with Parkinson's patients, note an association between the prescribed use of pramipexole (and other direct-acting dopamine agonist medications) and impulse control disorders, particularly pathological gambling. Two experiments examined the effects of acute pramipexole on rats' impulsive choices where impulsivity was defined as selecting a smallersooner over a larger-later food reward. In Experiment 1, pramipexole (0.1 to 0.3 mg/kg) significantly increased impulsive choices in a condition in which few impulsive choices were made during a stable baseline. In a control condition, in which impulsive choices predominated during baseline, pramipexole did not significantly change the same rats' choices. Experiment 2 explored a wider range of doses (0.01 to 0.3 mg/kg) using a choice procedure in which delays to the larger-later reinforcer delivery increased across trial blocks within each session. At the doses used in Experiment 1, pramipexole shifted choice toward indifference regardless of the operative delay. At lower doses of pramipexole (0.01 & 0.03 mg/kg), a trend toward more impulsive choice was observed at the 0.03 mg/kg dose. The difference in outcomes across experiments may be due to the more complex discriminations required in Experiment 2; i.e., multiple discriminations between changing delays within each session.
KeywordsPramipexole; D2/D3 agonist; Impulsivity; Choice; GamblingThe Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision DSM-IV-TR; American Psychiatric Association, 2000) classifies pathological gambling (PG) as one of several impulse control disorders. Several recent clinical reports suggest that individuals diagnosed with Parkinson's disease (PD) who are treated with dopamine (DA) agonist medications may demonstrate increased impulsivity and gambling activities which in some cases reaches pathological levels (for a review see Potenza et al., 2007). Other cases of DA agonist-related problem behavior have involved compulsive shopping and hypersexuality (Dodd et al., 2005;Driver-Dunckley et al., 2007;Giovannoni et al., 2000;Klos et al., 2005;McKeon et al., 2007;Munhoz et al., 2009;Voon et al., 2006a;Weintraub et al., 2006); two activities also classified by the DSM-IV-TR as impulse control disorders. A causal role of these DA agonist medications in the development of impulsive behaviors is suggested by the absence (or socially acceptable frequency) of impulse control disorders prior to drug therapy Corresponding Author: Gregory J. Madden, Department of Applied Behavioral Science, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, gmadden@ku.edu,. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omis...