Using STN DBS and medication reduction as a strategy to treat pathological gambling in Parkinson's disease

Parkinsonism Relat Disord. 2007 Aug;13(6):369-71. doi: 10.1016/j.parkreldis.2006.07.011. Epub 2006 Oct 16.


We describe two patients with Parkinson's disease (PD) who developed clinical criteria of pathological gambling addiction in the setting of increased dopamine replacement therapy (levodopa and dopamine agonist medications). The second patient showed also signs of dopamine dysregulation syndrome, with an addiction to dopaminergic medication. Neither patients responded to the standard therapy for gambling behavior, but dramatically improved after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) and early postoperative withdrawal of dopaminergic therapy. The possible therapeutic role of subthalamic nucleus deep brain stimulation (STN-DBS) on such a disabling behavior needs to be investigated prospectively.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Benzothiazoles / therapeutic use*
  • Deep Brain Stimulation / methods*
  • Dopamine Agonists / therapeutic use*
  • Gambling*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / pathology
  • Parkinson Disease / psychology*
  • Parkinson Disease / therapy
  • Pramipexole
  • Subthalamic Nucleus / physiopathology*
  • Subthalamic Nucleus / radiation effects


  • Benzothiazoles
  • Dopamine Agonists
  • Pramipexole