Skip to main content

Dopamine Agonist-Induced Impulse Control Disorders

  • Chapter
  • First Online:
A Case-Based Guide to Clinical Endocrinology

Abstract

Dopamine agonists (DA) are widely used in the management of prolactinomas, as they are largely effective in controlling tumor secretion and growth. Dopamine agonist administration is safe with only minor adverse effects reported in most cases (e.g., gastrointestinal symptoms and postural hypotension). Neuropsychiatric side effects such as impulse control disorders (ICD; e.g., pathological gambling, compulsive shopping, and hypersexuality) have been described in neurological patients treated for Parkinson’s disease and restless leg syndrome with high doses of DA. Accumulating evidence suggests that ICD in patients with prolactinomas treated with DA are not as rare as previously thought.

We describe a case of microprolactinoma in a perimenopausal female with no known psychiatric history. The patient developed disruptive symptoms of hypersexuality after treatment with cabergoline, which subsequently resolved when cabergoline was discontinued.

Increased awareness regarding possible psychiatric adverse effects with DA administration is needed among endocrinologists, and caution should be exerted in prescribing and monitoring treatment effects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Vroonen L, Daly AF, Beckers A. Epidemiology and management challenges in prolactinomas. Neuroendocrinology. 2019;109(1):20–7.

    Article  CAS  Google Scholar 

  2. Lim CT, Korbonits M. Update on the clinicopathology of pituitary adenomas. Endocr Pract. 2018;24(5):473–88.

    Article  Google Scholar 

  3. Hinojosa-Amaya JM, Johnson N, González-Torres C, Varlamov EV, Yedinak CG, McCartney S, et al. Depression and impulsivity self-assessment tools to identify dopamine agonist side effects in patients with pituitary adenomas. Front Endocrinol (Lausanne). 2020;11:579606.

    Article  Google Scholar 

  4. Voon V, Fernagut PO, Wickens J, Baunez C, Rodriguez M, Pavon N, et al. Chronic dopaminergic stimulation in Parkinson's disease: from dyskinesias to impulse control disorders. Lancet Neurol. 2009;8(12):1140–9.

    Article  CAS  Google Scholar 

  5. Voon V, Napier TC, Frank MJ, Sgambato-Faure V, Grace AA, Rodriguez-Oroz M, et al. Impulse control disorders and levodopa-induced dyskinesias in Parkinson's disease: an update. Lancet Neurol. 2017;16(3):238–50.

    Article  Google Scholar 

  6. Weintraub D, Koester J, Potenza MN, Siderowf AD, Stacy M, Voon V, et al. Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients. Arch Neurol. 2010;67(5):589–95.

    Article  Google Scholar 

  7. Greenman Y. Prolactinomas and menopause: any changes in management? Pituitary. 2020;23(1):58–64.

    Article  CAS  Google Scholar 

  8. American Psychiatric Association. Diagnostic and statistical manual of mental health disorders-V (DSM-V). Washington, DC: American Psychiatric Association; 2013.

    Book  Google Scholar 

  9. Dell’Osso B, Altamura AC, Allen A, Marazziti D, Hollander E. Epidemiologic and clinical updates on impulse control disorders: a critical review. Eur Arch Psychiatry Clin Neurosci. 2006;256(8):464–75.

    Article  Google Scholar 

  10. Grall-Bronnec M, Victorri-Vigneau C, Donnio Y, Leboucher J, Rousselet M, Thiabaud E, et al. Dopamine agonists and impulse control disorders: a complex association. Drug Saf. 2018;41(1):19–75.

    Article  CAS  Google Scholar 

  11. Corvol JC, Artaud F, Cormier-Dequaire F, Rascol O, Durif F, Derkinderen P, et al. Longitudinal analysis of impulse control disorders in Parkinson disease. Neurology. 2018;91(3):e189–201.

    Article  CAS  Google Scholar 

  12. Bancos I, Nannenga MR, Bostwick JM, Silber MH, Erickson D, Nippoldt TB. Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary adenomas: a case-control study. Clin Endocrinol. 2014;80(6):863–8.

    Article  Google Scholar 

  13. Barake M, Evins AE, Stoeckel L, Pachas GN, Nachtigall LB, Miller KK, et al. Investigation of impulsivity in patients on dopamine agonist therapy for hyperprolactinemia: a pilot study. Pituitary. 2014;17(2):150–6.

    Article  CAS  Google Scholar 

  14. Celik E, Ozkaya HM, Poyraz BC, Saglam T, Kadioglu P. Impulse control disorders in patients with prolactinoma receiving dopamine agonist therapy: a prospective study with 1 year follow-up. Endocrine. 2018;62(3):692–700.

    Article  CAS  Google Scholar 

  15. Martinkova J, Trejbalova L, Sasikova M, Benetin J, Valkovic P. Impulse control disorders associated with dopaminergic medication in patients with pituitary adenomas. Clin Neuropharmacol. 2011;34(5):179–81.

    Article  CAS  Google Scholar 

  16. Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z, et al. Dopamine agonist-induced impulse control disorders in patients with prolactinoma: a cross-sectional multicenter study. J Clin Endocrinol Metab. 2019;104(7):2527–34.

    Article  Google Scholar 

  17. Viana MC, Andrade LH. Lifetime prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the Sao Paulo metropolitan area, Brazil: results from the Sao Paulo megacity mental health survey. Braz J Psychiatry. 2012;34(3):249–60.

    Article  Google Scholar 

  18. Ozkaya HM, Sahin S, Korkmaz OP, Durcan E, Sahin HR, Poyraz BC, et al. The prevalence of impulse control disorders in patients with acromegaly and prolactinomas treated with dopamine agonists. J Endocr Soci. 2020;4:MON-293.

    Article  Google Scholar 

  19. Grall-Bronnec M, Sauvaget A, Perrouin F, Leboucher J, Etcheverrigaray F, Challet-Bouju G, et al. Pathological gambling associated with aripiprazole or dopamine replacement therapy: do patients share the same features? Rev J Clin Psychopharmacol. 2016;36(1):63–70.

    Article  CAS  Google Scholar 

  20. Vriend C. The neurobiology of impulse control disorders in Parkinson's disease: from neurotransmitters to neural networks. Cell Tissue Res. 2018;373(1):327–36.

    Article  CAS  Google Scholar 

  21. Weintraub D, Nirenberg MJ. Impulse control and related disorders in Parkinson's disease. Neurodegener Dis. 2013;11(2):63–71.

    Article  CAS  Google Scholar 

  22. Ioachimescu AG, Fleseriu M, Hoffman AR, Vaughan Iii TB, Katznelson L. Psychological effects of dopamine agonist treatment in patients with hyperprolactinemia and prolactin-secreting adenomas. Eur J Endocrinol. 2019;180(1):31–40.

    Article  CAS  Google Scholar 

  23. Ahlskog JE. Pathological behaviors provoked by dopamine agonist therapy of Parkinson's disease. Physiol Behav. 2011;104(1):168–72.

    Article  CAS  Google Scholar 

  24. Ben-Jonathan N, Hnasko R. Dopamine as a prolactin (PRL) inhibitor. Endocr Rev. 2001;22(6):724–63.

    Article  CAS  Google Scholar 

  25. Seeman P. Parkinson’s disease treatment may cause impulse-control disorder via dopamine D3 receptors. Synapse. 2015;69(4):183–9.

    Article  CAS  Google Scholar 

  26. MacDonald HJ, Stinear CM, Ren A, Coxon JP, Kao J, Macdonald L, et al. Dopamine gene profiling to predict impulse control and effects of dopamine agonist ropinirole. J Cogn Neurosci. 2016;28(7):909–19.

    Article  Google Scholar 

  27. De Sousa SM, Chapman IM, Falhammar H, Torpy DJ. Dopa-testotoxicosis: disruptive hypersexuality in hypogonadal men with prolactinomas treated with dopamine agonists. Endocrine. 2017;55(2):618–24.

    Article  Google Scholar 

  28. Bakker IC, Schubart CD, Zelissen PM. Successful treatment of a prolactinoma with the antipsychotic drug aripiprazole. Endocrinol Diabetes Metab Case Rep. 2016;2016:160028.

    PubMed  PubMed Central  Google Scholar 

  29. Burback L. Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania. Endocrinol Diabetes Metab Case Rep. 2015;2015:150100.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cristina Capatina .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Capatina, C., Poiana, C., Fleseriu, M. (2022). Dopamine Agonist-Induced Impulse Control Disorders. In: Davies, T.F. (eds) A Case-Based Guide to Clinical Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-030-84367-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84367-0_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84366-3

  • Online ISBN: 978-3-030-84367-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics