Dopaminergika-induziertes Pathologisches Glücksspiel

 

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Zusammenfassung

Störungen der Impulskontrolle und pathologisches Spielen sind Erscheinungen, welche bei einer dopaminergen Therapie bei Patienten mit Morbus Parkinson als mögliche Nebenwirkungen bekannt sind. Wir berichten über 2 Fälle von Dopaminergika-induziertem pathologischen Glücksspiel bei nicht an Morbus Parkinson erkrankten Patienten. Der erste Patient war ein 46-jähriger Mann, welcher im Rahmen einer Behandlung eines Restless-Legs-Syndroms mit Ropinirol größere Geldmengen über ein internetbasiertes Pokerspiel verloren hatte. Bei einem weiteren, ebenfalls 46-jährigen Patienten war Cabergolin zur Therapie eines Prolaktinoms verordnet worden, worunter es ebenfalls zur Ausbildung einer Spielsucht gekommen war. Die beschriebenen Fälle zeigen pathologisches Glücksspiel als mögliche Folge einer Therapie mit Dopaminagonisten und stützen die zunehmende Evidenz für das Auftreten pathologischen Spielens als unerwünschte Arzneimittelwirkung dopaminerger Therapien auch bei Patienten, die nicht an Morbus Parkinson erkrankt sind.

Abstract

Problems with impulse control and pathological gambling are known as possible side effects of dopaminergic therapy in patients with Parkinson’s disease. We report 2 cases of pathological gambling induced by dopamine agonists in patients without Parkinson’s disease. The first patient, a 46-year-old man, was treated with ropinirole for restless legs syndrome and had lost huge amounts of money in the context of internet-based poker game. Another 46-year-old male patient developed pathological gambling under treatment with cabergoline administered for prolactinoma. The two cases implicate pathological gambling as a possible consequence of dopaminergic treatment and support the increasing evidence regarding pathological gambling as an adverse drug reaction of dopaminergic treatment, also in patients who do not suffer from Parkinson’s disease.

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Dr. Maximilian Gahr

Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm

Leimgrubenweg 12 – 14

89075 Ulm

Email: maximilian.gahr@uni-ulm.de