Pramipexole - Problem Gambler Sues Doctor

[JanCarol]

Okay, this was in my Sunday Brisbane Courier Mail. (spotted by hubby)

 

http://www.couriermail.com.au/news/queensland/woman-suing-gp-over-claims-medication-made-her-a-compulsive-gambler/story-fnihsrf2-1227581066318

 

I will paraphrase.

 

A local woman, Margaret Faith Rimmer, is suing a doctor, Dr. Zoltan Bourne, for prescribing, and continuing to prescribe Sifrol (pramepexole, also branded Mirapex and Mirapexin) for restless legs.  The woman is asking for AU$ 952,000.  The prescription was for restless legs.

 

(we do not know what other drugs she was on, restless legs is often a side effect of other drugs, especially polypharmacy.)

 

Rimmer was prescribed 750 mcgs  of Sifrol in 2008 after consulting Bourne.  It was known at the time that the medication had side effects including compulsive behaviour and impulse control disorder, causing increased gambling, shopping, or sexual desire.  750 mcgs is the maximum recommended dose.  

 

In 2012, another neurologist asked her if she had been gambling or had "abhorrent sexual behaviour" from taking Sifrol.  Rimmer reported that she was gambling, and had never done so before.  This second neurologist sent a letter to Bourne, indicating the dangers of this drug.

 

In Sept 2013, Bourne increased the dosage to 1500 mcg.  In December 2013 (this gets confusing) the second neurologist gave the woman a diagnosis of "medication induced compulsive gambling," with a letter to indicate this.  Rimmer said that after the dosage was increased, her gambling substantially increased.

 

Pramepexole is a non-ergoline dopamine agonist which acts on D2L, D2S, D3 and D4.  It is used in Parkinsons, to ameliorate side effects from neuroleptics, and in Australia is approved on the PBS for restless legs.  In Bipolar depression, it is used up to 4500 mcg (in 3 doses) per day, and is claimed to have some efficacy in unipolar depression.

 

Common side effects include:  Headache, peripheral edema, hyperalgesia (Yeah, that would help with the restless legs, eh?), nausea and vomiting, sedation and somnolence, decreased appetite and weight loss, orthostatic hypotension, dizziness, lightheadedness and fainting, insomnia, hallucinations, twitching, twisting and unusual body movements (again, for the restless legs, right?), unusual tiredness or weakness.  More unusual effects include compulsive gambling, hypersexuality, overeating, punding.

 

It is being investigated as an aid for cluster headache - as well as to counteract PSSD in antidepressant cases, as well as the treatment of fibromyalgia.

 

Related drugs include:  Dexpramipexole (the enantiiomer of pramipexole), Piribedil, Ropinirole, Rotigotine, and Riluzole.

[Fresh]

Thanks JanCarol (and hubby).  Good to hear this is being pursued in Australia.

 

The article below is from 2010 . . ." . .  the first pramipexole gambling addiction trial ended in an $8.3

million judgment for the plaintiff against drug-maker Boehringer Ingelheim."

 

 

Pramipexole Lawsuits a Wake-Up Call for Prescribers

Allison Gandey

December 13, 2010

 

 

 

 

 

December 13, 2010 — The sometimes tragic personal toll of impulse control disorders associated with use of the Parkinson's drug pramipexole is now being debated in US and Canadian courtrooms, and a health law expert says these lawsuits have important implications for prescribers.

 

The drug, marketed under the brand name Mirapex and also used to treat restless legs syndrome, has been shown to trigger compulsive gambling, shopping, eating, and heightened sexuality.

 

In August, the first pramipexole gambling addiction trial ended in an $8.3 million judgment for the plaintiff against drug-maker Boehringer Ingelheim.

 

All physicians who regularly prescribe medications for which there could be significant and detrimental side effects should realize that they could also be named as defendants in such adverse reaction suits," Mr. Mandell said"

Full article here http://www.medscape.com/viewarticle/734153