Here’s some news that could put an interesting twist in the gambling addiction/genetics debate (not to mention supply new reasons to sue drug companies): ABC News reports that several of the drugs prescribed for Parkinson’s disease and restless legs syndrome can cause a range of dangerous behavioral side effects including increased drinking, drug use, risky sex, and gambling.
The drugs, which include Mirapex and Requip, are dopamine agonists, which mimic dopamine in the brain to boost the movement and coordination centers—and also stimulate the pleasure response by reinforcing certain behaviors. Unwitting patients who’ve taken the drugs have wound up with costly gambling habits, DUI arrests, and compulsive eating disorders, as well as even stranger effects—one man reportedly plays basketball for up to 36 hours at a time, while another compulsively fishes.
Given that more than 10 million prescriptions have been written for Mirapex alone, it’s not unlikely that we’ll see some serious fallout, be it motorists killed by a drunk driver on the drug, or an STD spike as a result of risky sexual practices (which are already on the rise among seniors, the demographic most likely to be taking meds for Parkinson’s and RLS).
As such, it’s worth it to start asking to what degree patients should be held legally responsible for their actions while taking the drug—and, perhaps even more importantly for lawyers, whether the drug companies can be held at all responsible for all that irresponsible boozing and sex.
July 17th, 2008 at 8:34 am
The dopamine agonist phenomena discussed in your article are very important.
The debate on whether addictions are caused by biological mechanisms and in particular genetic ones versus non-biological causes is long over though the other side of this issue hasn’t surrendered yet because they are making hundreds of billions of dollars off the psychobabble/moral/environmental paradigm. See my review paper on the science behind this theory war and the debate at: http://www.nvo.com/hypoism/hypoismhypothesis/ Another article discusses the evolutionary psychology and the brain mechanism given to us by evolution: http://www.nvo.com/hypoism/thehypoismaddictionhypothesis/ My 1996 book, Hypoic’s Handbook, goes through the entire paradigm debate including the addiction prevention, recovery, and public policy implications.
The addictions seen in the small group of Mirapex and Requip users is 100% in favor of the biological (and genetic) causation of addictions. Discontinuation and reuse studies show under these conditions the addictions disappear and reappear in these people. There’s no question this is a biological mechanism and real, not to be ignored, poo-poo’d or disrespected. The science of this needs to be worked out, but my guess is that as in addictions in general, there are certain people with certain particular genetic alleles of the reward system regulatory mechanism that get addictions under the biological influence of these dopamine agonists. A better understanding of this phenomenon will add insight into the causation of addictions and more evidence of the purely biological mechanism of addiction causation.
The main implications of all this is that the entire paradigm of addiction causation and understanding needs to be changed, dumping the current environmental/psychobabble paradigm (the hijacked brain hypothesis), so we can then move forward in ending the current addiction epidemic maintained by this paradigm and their damaging public policies, such as the drug war and addict discrimination.
My web site http://www.nvo.com/hypoism/door/ has much important information on all aspects of this mess.