A Genetic Assessment of Dopamine Agonist-Induced Impulse Control Disorder in Patients With Prolactinoma

Abstract

Context Dopamine agonist-induced (DA-induced) impulse control disorder (ICD) represents a group of behavioral disorders that are increasingly recognized in patients with prolactinoma. Objective We aimed to examine the genetic component of the underlying mechanism of DA-induced ICD. Methods Prolactinoma patients receiving dopamine agonist (cabergoline) treatment were included in the study. These patients were divided into two groups: patients who developed ICD due to DA and patients who did not. Patients were evaluated for polymorphisms of the DRD1, DRD3, COMT, DDC, GRIN2B, TPH2, OPRK1, OPRM1, SLC6A4, SLC6A3, HTR2A genes. Results Of the 72 prolactinoma patients using cabergoline, 20 were diagnosed with ICD. When patients with and without ICD were compared according to genotype frequencies; OPRK1/rs702764, DRD3/rs6280, HTR2A/rs6313, SLC6A4/rs7224199, GRIN2B/rs7301328, TPH2/rs7305115, COMT/rs4680, DRD1/rs4532 polymorphisms significantly increased in patients with DA-induced ICD. Conclusion Our results show that multiple neurotransmission systems affect DA-induced ICD in patients with prolactinoma.

Impulse Control Disorders in Southern Iraqi Patients Medicated With Cabergoline for Prolactinoma

“…There are studies suggesting that genetics may affect the susceptibility to ICDs in patients on cabergoline; for example, a study found that the prevalence of the DRD3 p.Se r9Gly (rs6280) CT genotype in Indian patients with Parkinsonism is a risk factor for developing ICDs [ 23 ]. Another study found that polymorphisms in the number of genes may increase the incidence of ICDs in cabergoline-treated prolactinoma significantly [ 24 ].…”

Treatment of hyperprolactinemia in women: A Position Statement from the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and the Brazilian Society of Endocrinology and Metabolism (SBEM)

“…Impulse control disorders are characterized by impulsive behaviors that interfere with the individual's daily life and include compulsive buying and eating, pathological gambling, punding (performance of repetitive tasks), and hypersexuality, among other manifestations. The risks and benefits of treatment with dopamine agonists in these circumstances must be assessed together with a psychiatrist to decide on the best course of action, if either maintaining the dopamine agonist at a lower dose with concurrent psychiatric monitoring/treatment or considering neurosurgery in cases involving tumor growth ( 16 , 17 ).…”