Pathological gambling (PG) is a potential complication related to the treatment of Parkinson disease (PD) with dopamine agonists (DA). The cause of this disorder is unknown, but altered dopamine neurotransmission may be involved.
We evaluated the efficacy and tolerability of the opioid antagonist naltrexone in the treatment of PG in PD.
Our cases included 3 patients with PD who developed PG after DA treatment.
Pathological gambling did not improve after reduction or discontinuation of DA. These patients responded poorly to serotonin reuptake inhibitors, whereas treatment with opioid antagonist naltrexone resulted in the remission of PG. Naltrexone treatment was well tolerated. In one patient, higher dose of naltrexone resulted in hepatic abnormalities, which resolved after dosage reduction.
The opioid antagonist naltrexone could be an effective option for the treatment of PG in PD.
*Department of Neurology, “S. Giovanni di Dio,” Crotone; †Neurological Science Institute–Council Research Centre; ‡Department of Pharmacology, University “Magna Graecia”, Catanzaro; §Department of Neuroscience, “G. Jazzolino” Hospital, Vibo Valentia; and ∥Department of Radiology, “Careggi” University, Florence, Italy.
Conflicts of Interest and Source of Funding: The authors have no conflicts of interest to declare.
Address correspondence and reprint requests to Domenico Bosco, MD, Department of Neurology, “S. Giovanni di Dio”, Via Largo Bologna, 88900 Crotone, Italy; E-mail: firstname.lastname@example.org