Predictors of impulsivity and reward seeking behavior with dopamine agonists

Three hundred consecutive patients taking DA either for Parkinson's disease (PD, 207), restless legs syndrome (RLS, 89), or both (4) were interviewed about changes in gambling, spending, sexual activity, or other impulsive activities subsequent to DA. Regression models identified risk factors for impulsivity. Overall, 19.7% reported any increased impulsivity: 30 gambling, 26 spending, 11 sexual activity, and 1 wanton traveling. Only 11/59 felt the change was deleterious. Increased impulsivity correlated with a younger age (p=0.01), larger doses of DA (p<0.001), and PD, as opposed to RLS (p<0.01), but this lost significance after correcting for dose (p=0.09). Increased impulsivity is common but usually not deleterious.