Impulse control and correlation to dopamine agonist serum concentrations in people with Parkinson's disease

Sara C Staubo; Ole Martin Fuskevåg; Mathias Toft; Ingeborg H Lie; Kirsti M J Alvik; Pål Jostad; Stein H Tingvoll; Hallvard Lilleng; Kristina Rosqvist; Elisabet Størset; Per Odin; Espen Dietrichs; Erik Sveberg Dietrichs

doi:10.1007/s00415-024-12870-8

Impulse control and correlation to dopamine agonist serum concentrations in people with Parkinson's disease

J Neurol. 2025 Jan 15;272(2):134. doi: 10.1007/s00415-024-12870-8.

Authors

Sara C Staubo^{1

2

3}, Ole Martin Fuskevåg^{4

5

6}, Mathias Toft^{1

2}, Ingeborg H Lie^{1

2}, Kirsti M J Alvik⁷, Pål Jostad⁸, Stein H Tingvoll⁸, Hallvard Lilleng^{9

6}, Kristina Rosqvist¹⁰, Elisabet Størset¹¹, Per Odin¹⁰, Espen Dietrichs^{12

13}, Erik Sveberg Dietrichs^{11

14

4

5}

Affiliations

¹ Department of Neurology, Oslo University Hospital, Rikshospitalet, Nydalen, PO Box 4950, N-0424, Oslo, Norway.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway.
⁴ Experimental and Clinical Pharmacology, Institute of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway.
⁵ Department of Laboratory Medicine, Division of Diagnostic Services, University Hospital of Northern Norway, Tromsø, Norway.
⁶ Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
⁷ Unicare Fram Rehabilitation Centre, Rykkinn, Norway.
⁸ Ringen Rehabilitation Centre, Moelv, Norway.
⁹ Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway.
¹⁰ Division of Neurology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
¹¹ Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway.
¹² Department of Neurology, Oslo University Hospital, Rikshospitalet, Nydalen, PO Box 4950, N-0424, Oslo, Norway. espen.dietrichs@medisin.uio.no.
¹³ Institute of Clinical Medicine, University of Oslo, Oslo, Norway. espen.dietrichs@medisin.uio.no.
¹⁴ Institute of Oral Biology, University of Oslo, Oslo, Norway.

Abstract

Background: Impaired impulse control is often seen in Parkinson's disease (PD) patients using dopamine agonists.

Methods: We performed a therapeutic drug monitoring study of 100 PD patients using ropinirole or pramipexole extended release. Three blood samples were collected on the same day. Serum concentrations were measured, and 24 h area under the curve (AUC) calculated. The validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) was used for assessing impulse control.

Results: Total ropinirole drug exposure showed weak, but significant correlation to the QUIP-RS score. No correlation between pramipexole serum concentrations and QUIP-RS was found. In ropinirole patients, both agonist dose and total dopaminergic treatment were correlated with QUIP-RS. Duration of ropinirole treatment correlated with impaired impulse control, and duration of dopaminergic treatment of any type correlated with QUIP-RS scores in both ropinirole and pramipexole patients.

Conclusions: Our main finding is that impaired impulse control is correlated to both total drug exposure (AUC) and dopamine agonist dose for ropinirole, but not for pramipexole. These observations indicate that different strategies may be useful for treating PD patients with impaired impulse control: ropinirole dose reduction could be beneficial, whereas pramipexole treatment may have to be stopped.

Keywords: Dopamine agonist; Impulse control disorder; Parkinson’s disease; Pharmacology.

MeSH terms

Aged
Antiparkinson Agents* / adverse effects
Antiparkinson Agents* / blood
Antiparkinson Agents* / therapeutic use
Area Under Curve
Benzothiazoles* / adverse effects
Benzothiazoles* / blood
Benzothiazoles* / therapeutic use
Disruptive, Impulse Control, and Conduct Disorders* / blood
Disruptive, Impulse Control, and Conduct Disorders* / chemically induced
Dopamine Agonists* / adverse effects
Dopamine Agonists* / blood
Dopamine Agonists* / therapeutic use
Dose-Response Relationship, Drug
Drug Monitoring
Female
Humans
Indoles* / adverse effects
Indoles* / blood
Indoles* / therapeutic use
Male
Middle Aged
Parkinson Disease* / blood
Parkinson Disease* / complications
Parkinson Disease* / drug therapy
Pramipexole

Substances

Dopamine Agonists
Pramipexole
ropinirole
Benzothiazoles
Indoles
Antiparkinson Agents