Thursday, January 14, 2010

Sinemet (Levodopa) & Gambling! Who Knew?

Only those who read product labels, because this definitely hasn't been publicized.

I was just perusing the most recent (12/2008) Sinemet product insert and i found the following paragraph:

"There have been reports of patients experiencing intense urges to gamble, increased sexual urges, and other intense urges, and the inability to control these urges while taking one or more of the medications that increase central dopaminergic tone and that are generally used for the treatment of Parkinson’s disease, including SINEMET. Although it is not proven that the medications caused these events, these urges were reported to have stopped in some cases when the dose was reduced or the medication was stopped. Prescribers should ask patients about the development of new or increased gambling urges, sexual urges or other urges while being treated with SINEMET. Patients should inform their physician if they experience new or increased gambling urges, increased sexual urges, or other intense urges while taking SINEMET. Physicians should consider dose reduction or stopping the medication if a patient develops such urges while taking SINEMET."

The fact that (ballparking) 95% of all cases of gambling that have been blamed on dopamine agonists were also taking levodopa has been consistently disregarded by study authors and not even mentioned in news articles.

AND anyone who has taken the fact that Boehringer Ingelheim, which has come under relentless fire for Mirapex, voluntarily (I believe) put a similar warning on their label a couple of years ago as an admission of guilt must now ask themselves why Merck/Bristol Myers Squibb would do the same, if it was voluntary, or why they would be required to, if it was not (I haven't been able to determine which it was) when they have come under no fire at all.

I would also ask why this hasn't been publicized - *vastly* more people are taking levodopa than are taking dopamine agonists.

Actually, I don’t think there is enough evidence to support either drug, taken as prescribed, causing such behavior – however, if dopamine replacement therapy must be blamed, then they both must be considered possible culprits – reports linking levodopa to hypersexuality, for example, far pre-date the approval of Mirapex.

It looks like they also added language about melanoma...

I haven't seen that in the news, either - has anyone else?

Most disturbing to me is that, if there really is a possible association between Sinemet and gambling, this supports my position that dopamine agonists have been being unfairly maligned.

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