Effect of Dopaminergic Therapy on Impulse Control Disorders in Patients With a Prolactinoma

Abstract

Background: Studies have reported an increase in the incidence of impulse control disorders (ICDs) in patient groups treated with dopamine agonists (DAAs), especially in Parkinson disease (PD). However, very few studies have reported on ICDs in individuals with a prolactinoma who were treated with DAAs.Objective: To see whether a DAA by itself causes ICDs in individuals with a prolactinoma by controlling the susceptibility to impulsivity by excluding individuals with other risk factors for ICDs. Method:We compared the performance of 31 individuals with a prolactinoma receiving DAA therapy (DAA+) on various behavioral scales and the Iowa gambling task (IGT), a neuropsychological instrument that measures risky decision-making, with the performance of 20 individuals with a prolactinoma who were not on DAA therapy (DAA−) and 30 healthy controls (HC).Results: There was no significant difference among the groups concerning performance on the Zuckerman Sensation Seeking Scale-V, Minnesota Impulse Disorders Interview, Barratt Impulsiveness Scale-11, or IGT. No correlation was found between the scores on these scales and the duration or dose of DAA in the DAA+ group. The incidence of ICDs was 25.8% in the DAA+ group, 15% in the DAA− group, and 16.7% in the HC. The differences among the groups did not reach statistical significance. Conclusion:Individuals who are under treatment with low-dose, D 2 -selective DAAs for a prolactinoma do not face an increased risk for ICDs, especially when they are carefully screened for any psychiatric comorbidity that may also display impulsivity.

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

“…In 2019, a multicenter study detected an ICD prevalence of 17%, with hypersexuality being the most common type, occurring mostly in males, as in our study [ 18 ]. Another study found a prevalence of 25.8% in the cabergoline-treated group as compared to 15% in the non-cabergoline-treated group, and this did not reach statistical significance, but compared to our study, the prevalence of ICDs in the control group was much higher [ 19 ]. The study by Bancos et al had comparable results, with 24.8% in patients versus 17.1% in the control group, but was non-significant [ 20 ].…”

Recent Perspectives on Impulse Control Disorder in Dopamine Agonist-Treated Patients in Endocrine Practice

“…2 illustrates the notably wide distribution in the observed frequency of ICDs across various published studies involving patients with PAs/disorders undergoing DA therapy. [8][9][10][11][12][13][14][15][16][17][18][19] This variation can be attributed to many factors, as demonstrated in ►Table 1. [7][8][9][10][11][12][13][14][15][16][17][18][19] These factors include disparities in study demographics (patients with prolactinomas vs. other adenomas or pituitary disorders), sex distribution, study methodologies (cross-sectional vs. prospective designs), the inclusion or exclusion of wellmatched control groups, and nuances in DA therapy (type, duration, dosage, current or prior usage, cumulative dosage).…”

“…[8][9][10][11][12][13][14][15][16][17][18][19] This variation can be attributed to many factors, as demonstrated in ►Table 1. [7][8][9][10][11][12][13][14][15][16][17][18][19] These factors include disparities in study demographics (patients with prolactinomas vs. other adenomas or pituitary disorders), sex distribution, study methodologies (cross-sectional vs. prospective designs), the inclusion or exclusion of wellmatched control groups, and nuances in DA therapy (type, duration, dosage, current or prior usage, cumulative dosage). 6 Furthermore, variations in assessment tools (both in quantity and type), whether assessments were self-reported or conducted by health care professionals or experts in ICDs and the presence of additional risk factors for ICD development (smoking, alcohol consumption, history of depression/ mental illness, and family predisposition to mental health conditions) can all contribute to the frequency of ICD.…”