Parkinson medication leads to gambling addiction

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Monique

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This a really strange side-effect: patients who use the much-prescribed Parkinson drug Mirapex (pramipexole) have an increased risk of developing addictions, for instance gambling, sex, or shopping. When the dose of the drug is decreased, the addictions disappear. I wonder what the etiology would be.

http://www.news-medical.net/?id=11626
http://archneur.ama-assn.org/cgi/content/full/62.9.noc50009v1 [Broken]
 
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DocToxyn

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That's a pretty dramatic demonstration of the power thaqt neurochemistry holds over our behavior. As I would have predicted, the Annals paper speaks to the dopamine circuitry that is affected in Parkinson's and the subsequent drug therapy. This circuitry, in addition to it role in motor function, also serves as a reward/reinforcement pathway and this is the function that appears to have been modified by the drug. All the classic reward-mediated behaviors like sex, eating, drug abuse were mentioned as being affected in the case studies from that paper (it's a little harder to study gambling addiction in rodents, although probaly not impossible). The receptor pharmacology/distribution is probably what ultimately defines the condition since this particular drug has a greater affinity for the D3-type of dopamine receptor than for other receptors of that class and thus is able to mimic dopamine activation of these particular receptors at rather low doses.
 
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Monique said:
This a really strange side-effect: patients who use the much-prescribed Parkinson drug Mirapex (pramipexole) have an increased risk of developing addictions, for instance gambling, sex, or shopping. When the dose of the drug is decreased, the addictions disappear. I wonder what the etiology would be.

http://www.news-medical.net/?id=11626
http://archneur.ama-assn.org/cgi/content/full/62.9.noc50009v1 [Broken]
I saw that too. Weird. Maybe this will lead to new trreatments for addictions? One can hope it will give us that sort of insight.

You probably also saw the link between turmeric and reduced risk of melanoma. Strange! It caught my eye because turmeric was show a year ago to have a strongly beneficial effect against cystic fibrosis. Curcumerin (sp?) appears to be the active agent in both cases.
 
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Monique

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pattylou said:
Curcumerin (sp?) appears to be the active agent in both cases.
Curcuma. That's also interesting.
 
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BTW, black pepper, or piperine (which is in black pepper), increases absorption of curcumin by inhibiting the appropriate P450 enzyme (CYP3A4). Without inhibition of CYP3A4, very little curcumin is absorbed:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9619120&query_hl=7

Planta Med. 1998 May;64(4):353-6.

Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers.

Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS.

Department of Pharmacology, St. John's Medical College, Bangalore, India.

The medicinal properties of curcumin obtained from Curcuma longa L. cannot be utilised because of poor bioavailability due to its rapid metabolism in the liver and intestinal wall. In this study, the effect of combining piperine, a known inhibitor of hepatic and intestinal glucuronidation, was evaluated on the bioavailability of curcumin in rats and healthy human volunteers. When curcumin was given alone, in the dose 2 g/kg to rats, moderate serum concentrations were achieved over a period of 4 h. Concomitant administration of piperine 20 mg/kg increased the serum concentration of curcumin for a short period of 1-2 h post drug. Time to maximum was significantly increased (P < 0.02) while elimination half life and clearance significantly decreased (P < 0.02), and the bioavailability was increased by 154%. On the other hand in humans after a dose of 2 g curcumin alone, serum levels were either undetectable or very low. Concomitant administration of piperine 20 mg produced much higher concentrations from 0.25 to 1 h post drug (P < 0.01 at 0.25 and 0.5 h; P < 0.001 at 1 h), the increase in bioavailability was 2000%. The study shows that in the dosages used, piperine enhances the serum concentration, extent of absorption and bioavailability of curcumin in both rats and humans with no adverse effects.

PMID: 9619120
 
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We're having curry tonight!

:)
 

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