First a few rare cases, collected in the thesis of Dr. D. Vincent ( here) and now a few months, fifteen, twenty, twenty-five cases with serious personal injury and family , financial and moral, even with legal consequences.
So let's talk.
ages? All
The ATCD pathological gambling, compulsive shopping or hypersexuality ? No
The dopaminergic involved? All.
doses ? Not high at all
prescriptions? Absolutely classic
consequences? Catastrophic, dramatic, monstrous ...
suicide attempts often total loss of self-esteem, depression aggravated ...
short, something to be upset and decide to "do something "
The first action TABOO TALK ABOUT IT WITHOUT
1 / For the human dramas (divorce, loss of any family environment, social relations, of its property) shall cease on or quickly, the MP is enough "rich" in disorders of any type not to add yet more misery.
2 / For that new cases are diagnosed and treated earlier
3 / For all that come forward that will help identify the statistical risks, currently estimated at less than 4 -5% of people under dopamine, the circumstances of occurrence and, especially the mechanisms that trigger these disorders without "prodrome", ie without premonitory signs.
The second action: BETTER KNOWN
1 / Finally, low risk but it can happen at anytime and under any dopaminergic treatment:
Imagine in your family, a nice and polite Mr. X, 76, maybe your father or your husband .... that after several years of MP who made it very very tired and Calm and slow turns abruptly to go out, buy women's underwear lace pink and walk in these outfits light at home, by saying he has always dreamed of being a prostitute ...
Imagine your wife so worthy and good mother, for whom the diagnosis of PD was a drama in which she has admirably drawn for the balance of the whole family, and, suddenly, the hand night without telling anyone, play casino and returned with a few thousand euros of debt, looking haggard, but without the slightest remorse, before attacking a day on websites XXX while you work to feed the family ...
You will then understand better why you MUST do something
2 / mechanisms: Several factors are involved:
- The person, not in its history, always impeccable, but his age (more common for fifty years) and in particular susceptibility testing possible without
- The molecule used, but that lack proper statistical studies for the moment and figures from the U.S. are biased requirements more frequent Pramipexole in North America
- The prescribed dose, we have seen, is not necessarily high for the trip, but the troubles worsen with the rise in the number of mg per day
- The variability of the rate of intracerebral dopamine and the famous pulsatility we are talking about for quite some time now as a key factor for triggering the motor disorders of levo-dopa-induced disease.
No surprise indeed for this factor, since both the motor control system that rewards go through the "yard" the basal ganglia, namely the sub-thalamic nucleus and its mechanisms of potentiation expressed identical for both control systems.
Without doubt, a more detailed optimization of dopaminergic treatments would help greatly to understand and curb the compulsive phenomena as dyskinesias ...
The third activity: THERAPEUTIC PROTECT OUR ACHIEVEMENTS
Do not fall into the trap of "this drug is dangerous because it causes compulsive disorder" because all are but just a little and, apart from these negative effects, their contribution our quality of life is undeniable.
So no drug-poison but a good crowd surveillance, evidence of improved and optimized and customized requirements frankly.
For " practice know everything", read here
