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From Blessing to Curse?

Drugs that relieve Parkinson's symptoms may also trigger odd urges: jet skiing up the coast, collecting toys or gambling compulsively

May 23, 2006 | Los Angeles Times

Faced with steady deterioration from Parkinson's disease, Jim Sweet leapt at the chance to try a new drug that promised to relieve the tremors brought on by the death of cells deep in his brain.

Like older Parkinson's medicines, Mirapex could bolster the fading supply of a critical brain chemical called dopamine. It was a blessing for Sweet until something unusual started happening.

First, he started buying things in EBay auctions: a camera, a leather reclining chair, a big-screen TV, sunglasses, costume jewelry and dozens of other items. He dived into online gambling, lottery tickets and penny stocks. Before long, he was disappearing for days to play slot machines at Indian casinos near his home in Rancho Cucamonga.

He ran through his savings and pawned his CD collection, his children's video game player and his wedding ring.

Gambling "was something I could not turn off," said Sweet, a 45-year-old former middle school teacher.

Although Mirapex and similar dopamine drugs have helped thousands of Parkinson's patients, researchers are beginning to detect a small group for which the medicine seems to act like a jolt of electricity, triggering bizarre, out-of-control urges.

According to a University of Toronto study presented last month, as many as 1 in 15 patients taking the drugs potentially thousands of people may have compulsive reactions.

An elderly California widower started wearing dresses, heels and lipstick; one man became obsessed with fast driving and abandoned his job to ride a jet ski up the California coast, according to a study by USC researchers.

Drug makers say they are monitoring reports but so far the rate of compulsions does not exceed that of the general population. One company chalked up complaints to coincidence.

"If someone takes an aspirin and they gamble, does that mean the aspirin did it?" asked Dr. David Hosford, a scientist at GlaxoSmithKline, maker of the dopamine drug Requip.

People who say their lives were shattered by their strange urges have filed lawsuits against drug makers. Although their compulsions disappeared after they stopped taking the drugs, some patients say they are still haunted by their experiences.

After spending $20,000 on prostitutes, phone sex and pornographic films, a married churchgoer in his 50s said he was troubled by the sexual desires seemingly uncorked by the drug.

"Was that the monster in the closet?" asked the man, a participant in a USC study who did not want his name published out of embarrassment. "Is that who I am really and the drug just opened the door?"

Sweet, a compact man who once studied for the ministry, can only guess where his compulsion came from.

He had barely been inside a casino before, although he remembered he and his wife once won $800 in Las Vegas. Thrilled, they bought an entertainment center for the family.

His life was happy and predictable until one day nine years ago when his left arm froze against his side during a church league basketball game. Weeks later, his arm shook as he grasped the hand of a teammate to form a prayer circle.

They were the first signs of Parkinson's disease, which affects 500,000 to 1 million Americans, most of them elderly. Sweet was 36, the father of two young children.

Parkinson's is caused by the death of cells that produce dopamine, a neurotransmitter that carries messages along the brain's pathways. A shortage of the chemical causes poor coordination, shaking and bad balance. With time, symptoms include incontinence, difficulty talking and sudden paralysis. There is no cure.

Sweet soon began taking the standard Parkinson's drug, levodopa, which is converted to dopamine in the brain.

Although his tremors disappeared, Sweet knew the decades-old medicine carried some undesirable side effects, including involuntary tongue movements, grimacing and head bobbing. So he switched to Mirapex, marketed by German drug maker Boehringer Ingelheim. The drug, which did not carry those side effects, had been approved a year earlier for patients in the early stages of Parkinson's.

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