“PROBLEM AND PATHOLOGICAL GAMBLING IN PARKINSON’S DISEASE”
D. Crockford, Dept. of Psychiatry, U of Calgary
Again, adapted from the Summary
“Parkinson’s disease is a neurodegenerative disease
resulting from a loss of dopamine producing cells in the brain.
Recent reports have described treatment-emergent gambling
problems in some patients, especially those treated with
dopamine-enhancing agents. Reports to date have not examined
patients in a systematized fashion using validated
instruments, nor have they attempted to delineate whether emergent
gambling problems relate to comorbidity, treatment of the
Parkinson�s disease process, or cognitive status. A study of
patients with moderate to advanced Parkinson�s disease
would help to characterize this phenomenon and form a basis for
further understanding of the neurobiological basis of
problem and pathological gambling.”
What They Were Looking at:
The objective was to determine whether or not the 12-month
prevalence of problem and pathological gambling in patients
with Parkinson’s disease was greater than in a comparable
community sample. They also wanted to determine whether or
not any increased prevalence of problem gambling that might
be found could be attributed to co-morbidity.
What They Found:
“Primary results were that the 12 month prevalence of
problem and pathological gambling in the Parkinson’s disease
sample was 9.3% compared to 1.6% in the community sample.”
Dr. Crockford states:
“The increased prevalence was not accounted for by
demographic factors, cognitive impairment, co-morbid
depression/anxiety symptoms or substance abuse. All patients were on
dopamine replacement and/or agonists.
The increase prevalence was not specific to the type of
dopamine agonist used, however, most subjects with problem or
pathological gambling reported a temporal association
between the onset of gambling and starting treatment for
Parkinson’s disease. ”
Dr. Crockford concludes that the study seems to confirm
that problem and pathological gambling is more prevalent in
patients with moderate to severe Parkinson’s disease treated
with dopamine replacement and/or agonists. The increased
prevalence is not attributable to psychiatric or substance
use co-morbidity.
http://www.abgaminginstitute.ualberta.ca/crockford.cfm
Notes: What is happening here?
Are the various medications leading to the increased risk
of the problem gambling? Patients were using different
types of dopamine agonists though.
Or is there a threshhold of neurodegenerative change at
which treatment with dopamine agonist medications is likely to
start, and that extent of change/ damage is simply
associated with the problem gambling?
Or is it something unrelated?
