Impulse Control Disorder in a Patient with Invasive Prolactinoma on Dopamine agonist Therapy: A Case Report

Abstract

Prolactinomas constitutes a major bulk of pituitary adenomas. All symptomatic prolactinomas require dopamine agonist (DA) therapy. Impulse control disorders (ICD) or pathological behaviours are rare adverse events described with use of DA. Herein we are describing a male patient with pathological gambling and doctor shopping following use of bromocriptine and higher dose of cabergoline.The pathological behaviour disappeard after debulking surgery, reduction in cabergoline dose and several sessions of counselling. Physicians prescribing DA should be aware of this potential adverse event.This should be emphasized to the patient and family members before starting DA and physician should be inquisitive for eliciting pathological behaviour on follow up.