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Researchers have used an adverse event database to examine 1,580 impulse control disorders (ICD) reports from 22 countries. Of these, 710 reports involved dopamine agonists. Between 6 and 24 per cent of people taking dopaminergic agonists seem to develop ICD, such as pathological gambling, hypersexuality, compulsive shopping and binge eating.

Dopaminergic agonists were associated with 10 ICDs, most commonly pathological gambling or gambling (51.5 per cent of the reports), hypersexuality (29.4 per cent) and compulsive shopping (12.8 per cent). Other ICDs mentioned included: binge eating (7.7 per cent); excessive masturbation (3.5 per cent); compulsive sexual behaviour (3.3 per cent); kleptomania (2.6 per cent); and excessive sexual fantasies (1.6 per cent).

Dopaminergic agonists were strongly associated with ICD (proportional reporting ratio [PRR] 277.6). In other words, ICD occurs about 278 times more frequently with dopaminergic agonists than other drugs. The association was strongest for pramipexole (PRR 455.9) and ropinirole (PRR 152.5), which preferentially stimulate dopamine D3 receptors. Aripiprazole, a D3 partial agonist, also seemed to increase ICD risk (PRR 8.6).

The authors say that the €findings confirm and extend the evidence€ suggesting that dopaminergic agonists are associated with serious ICDs. Indeed, they noted the €large€ magnitude of the effects and highlighted the importance of prominent warnings.