What drugs modify the risk of iatrogenic impulse-control disorders in Parkinson’s disease? A preliminary pharmacoepidemiologic study


Autoři: Nakyung Jeon aff001;  Marco Bortolato aff002
Působiště autorů: College of Pharmacy, Chonnam National University, Gwang-ju, Republic of Korea aff001;  Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah, United States of America aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227128

Souhrn

Introduction

Parkinson’s disease (PD) patients treated with pramipexole (PPX) and ropinirole (ROP) exhibit a higher risk of developing impulse control disorders (ICDs), including gambling disorder, compulsive shopping, and hypersexuality. The management of ICDs in PD is challenging, due to the limited availability of effective therapeutic alternatives or counteractive strategies. Here, we used a pharmacoepidemiological approach to verify whether the risk for PPX/ROP-associated ICDs in PD patients was reduced by drugs that have been posited to exert therapeutic effects on idiopathic ICDs–including atypical antipsychotics (AAs), selective serotonin reuptake inhibitors (SSRIs), and glutamatergic modulators (GMs).

Methods

To quantify the strength of the associations between PPX/ROP and other medications with respect to ICD risk, odds ratios (ORs) were calculated by multivariable logistic regression, adjusting for age, gender, marital status race, psychiatric comorbidities, and use of cabergoline and levodopa.

Results

A total of 935 patients were included in the analysis. Use of GMs, SSRIs, and AAs was not associated with a decreased ICD risk in PD patients treated with PPX/ROP; conversely, ICD risk was significantly increased in patients treated with either GMs (Adjusted Odds Ratio, ORa: 14.00 [3.58–54.44]) or SSRIs (ORa: 3.67 [1.07–12.59]). Results were inconclusive for AAs, as available data were insufficient to compute a reliable ORa.

Conclusions

These results suggest that some of the key pharmacological strategies used to treat idiopathic ICD may not be effective for ICDs associated with PPX and ROP in PD patients. Future studies with larger cohorts are needed to confirm, validate, and extend these findings.

Klíčová slova:

Antipsychotics – Depression – Diagnostic medicine – Dopamine – Drug research and development – Drug therapy – Levodopa – Parkinson disease


Zdroje

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