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Correspondence |

Gambling and Parkinson Disease

Cathy Lu, BSc; Aamir Bharmal; Oksana Suchowersky, MD, FRCPC, FCCMG
Arch Neurol. 2006;63(2):298. doi:10.1001/archneur.63.2.298-a.
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The article by Dodd et al1 described 11 patients with Parkinson disease who developed pathological gambling. The authors concluded that because pramipexole was the agonist involved in 9 of the 11 cases, and in 10 of 17 cases reported in the literature, pramipexole may result in gambling to a higher degree as compared with the other agonists, due to its disproportionate stimulation of dopamine D3 receptors.

However, although the majority of patients with pathological gambling were taking pramipexole in this study, the total number of patients who were treated with the various agonists was not reported. If many more patients were treated with pramipexole as compared with the other 2 agonists (which is the case in many centers in North America), then it may appear that pramipexole is more responsible than the other agonists unless the denominator (total number of treated patients) is included in the assessment. Similarly, the small number of cases reported in the literature should not be used to reach this conclusion.

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