Subject: Amantadine for Pathological Gambling in PD
Amantadine reduces pathological gambling in Parkinson’s disease patients taking dopamine agonists, according to a new study.
Seventeen PD patients with pathological gambling uncontrolled by medication changes, counseling, or behavioral strategies were randomized to receive 200 mg/day amantadine or placebo for 4 weeks, followed by a 1-week washout and crossover to the other arm.
Five patients dropped out due to medication side effects. Amantadine reduced scores on both the Symptom Assessment Scale and Yale-Brown Obsessive-Compulsive Scale by 80% compared to baseline, while placebo produced no change. Daily gambling expenditures, which were 2% of salary before treatment, were abolished in 7 patients, and reduced by 75% to 90% in 5 patients. Effects were seen within 4 days of treatment.
“The effect of amantadine was beyond expectations,” the authors conclude, “as a financially devastating compulsive behavior was completely abolished or markedly reduced in all patients. Evidence of this effect might help neurologists who are forced to deal with PD patients affected by pathological gambling.”
Pathological gambling in Parkinson disease is reduced by amantadine
A Thomas, L Bonanni, F Gambi, A Di Ioro, M Onofrj
Ann Neurol 2010;68:400-404
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