Dopamine agonists: pathological gambling, increased libido, and hypersexuality

Healthcare professionals should warn patients that compulsive behaviour with dopamine agonists may be dose-related.

• From: Medicines and Healthcare products Regulatory Agency
• Published: 11 December 2014

• Therapeutic area: Endocrinology, diabetology and metabolism, Neurology

Article date: August 2007

Dopamine agonists (eg, apomorphine [APO-go], bromocriptine [Parlodel], cabergoline [Cabaser, Dostinex], levodopa, pergolide [Celance], piribedil, pramipexole [Mirapexin], quinagolide [Norprolac], and ropinirole [Adartrel▼, Requip]) are used in the management of patients with Parkinson’s disease; other uses include restless legs syndrome and endocrine disorders.

Evidence from spontaneous adverse reaction reports and the literature^{[footnote 1]}, ^{[footnote 2]} suggest that pathological gambling and increased libido, including hypersexuality, may be rare class effects of dopamine agonists. ^{[footnote 3]}

Product information for medicines that contain dopamine agonists or levodopa, or both, is being updated to include the following wording:

• Special warnings and precautions for use:

  • Pathological gambling, increased libido and hypersexuality have been reported in patients treated with dopamine agonists for Parkinson’s disease, including <Product/Drug name>

• Undesirable effects:

  • Patients treated with dopamine agonists for treatment of Parkinson’s disease, including <Product/Drug name>, especially at high doses, have been reported as exhibiting signs of pathological gambling, increased libido and hypersexuality, generally reversible upon reduction of the dose or treatment discontinuation

Healthcare professionals are advised to warn patients about these possible side-effects, and to inform patients to seek help from their doctor if they, their family, or their carer notice that their behaviour is unusual.

 

Article citation: Drug Safety Update August 2007; Vol 1, Issue 1: 6

1. Dodd M, et al. Arch Neurol 2005; 62: 1377–81. ↩

2. Klos KJ, et al. Parkinsonism Related Disorders 2005; 11: 381–86. ↩

3. MHRA Public Assessment Report: Dopamine agonists: Pathological gambling and increased libido are potential class effects of these drugs. ↩

Published 11 December 2014