Is There a Link Between Gambling and Medication?

This is a follow up to a previous article written in July 2008 regarding the link between gambling addictions and medication designed to treat the symptoms of Parkinson’s disease.

The Mayo Clinic, which is based in the United States, has issued a new report discussing the case of the development of an unintentional compulsive gambling disorder following a course of medication in some of its patients.

 

Although the exact figures relating to the link between medications and compulsive gambling is, as yet, unknown, studies have shown that the treatment of certain neurological disorders with medication that stimulates dopamine receptors in specific areas of the brain do appear to have a key role in the original development of a gambling disorder in the patients that were studied.

The research is groundbreaking, and the Mayo Clinic is the first medical centre to have discovered a link between compulsive behaviour and patients presenting, and being treated for, Restless Leg Syndrome (RLS).

Restless Leg Syndrome, as the name implies, is a neurological condition that is recognised as an overriding compulsion for a person to move their legs, it is characterised by extreme discomfort in the legs which in turn produces an uncontrollable urge to move, in order to counter the unpleasant sensations that are occurring.

There is no known cure for RLS, but it is controlled with similar medication to that which is used to treat Parkinson’s disease, and herein lays the problem of the development of a compulsive gambling addiction, they are both dopamine affecting medications.

The development of compulsive behaviours in patients who are treated for Parkinson’s disease have been well documented, these patients need to take fairly high doses of medications which are classified as dopamine agonists.

The latest research, however, has now shown that it is not merely the patients on the highest doses (i.e. Parkinson’s patients); the development of gambling disorders is also found in other patients taking dopamine agonists.

However, the study found that only a small number of patients with RLS will go on to develop a gambling disorder when placed on dopamine agonists. One suggestion forwarded by the authors of the study is to ensure that doctors who are prescribing medication for RLS also screen their patients for compulsive behaviour throughout the duration of their medication.

Doctors should also take a full medical history from their patient for past examples of compulsive behaviour. The research also showed that the compulsion for gambling may increase with higher doses of medication, and so those patients should be screened more closely.

Gambling which can be classified as pathological is known as an impulse control disorder, and the Mayo Clinic has previously identified the development of such disorders in 11 patients who were being treated for Parkinson’s disease.

Maja Tippmann-Peikert has described how “Although pathologic gambling has already been recognized in patients with Parkinson disease who often took high doses of dopamine agonists, the current report suggests that pathological gambling is not restricted to patients with Parkinson disease — and also can occur at low dosages. Physicians should not only monitor Parkinson disease patients for this behaviour but also screen their RLS patients who may be on much lower doses of dopamine agonists.” Maja Tippmann-Peikert, M.D., is one of the lead authors of the Mayo Clinic research into restless legs syndrome.

 

Included in the factors above is the encouragement of the patient and their significant others to report any tendencies towards compulsive behaviour that may arise.

The study did find that the development of a compulsive gambling disorder was reversible on the cessation of the medication, or its reduction, or the changing of the medication completely. Obviously the importance of these changes cannot be underestimated and patients must be helped before they develop debts, and ruin relationships and careers.

The significance of this study is substantial; it is the first study to link medication to gambling disorders in diseases other than Parkinson’s disease. The study documented three patients who were suffering from RLS. Their gambling disorders were only discovered when they were being evaluated at the Mayo Clinic Sleep Disorders Centre. Although the sample is small, the authors believe that similar results will be found in other patients who are on prescription for dopamine agonists, and as such the study should be taken seriously by the medical profession.

The neurologists estimated that the gambling disorders began to emerge at around the 9^th month of medication; they speculate that the gambling problems are becoming more prevalent due to the development of a new generation of dopamine agonists, which are thought to be affecting neural pathways that are involved in the roles of motivation, emotion and reward behaviour.

 

One example from the study is that of a woman who has a five year history of RLS symptoms at night, including a creeping sensation and the urge to move her legs, two years before being seen at the Mayo Clinic Sleep Disorders Centre the woman had been officially diagnosed with the syndrome and been placed on a dopamine agonist medicine.

 

The symptoms of RLS were improved once the medication began, but, a new and problematic behaviour began to emerge, she developed a compulsion for visiting casinos and participating in gambling games, when the medication was increased, her urge to gamble also increased. Prior to her commencement on the dopamine agonist medication, she had no history of compulsive gambling and even viewed gamblers as “unfortunate individuals”; she lost over $100, 000 through gambling. Once the Mayo Clinic took her off the medication her gambling compulsion disappeared as quickly, and completely, as it had arrived. Her RLS is being treated with an alternative medicine and she has no recorded side effects.

 

Click here to read an article about the link between gambling and medication used to treat Parkinson's disease