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\t\t\t\t\t\tCommonly used drug can cause uncontrollable urge to gamble and have sex, FDA says<\/a><\/p>\n My impulse control disorder started slowly a few years into taking pramipexole. My RLS symptoms had returned, worse than before, and the doctor increased my dose (a phenomenon known as augmentation<\/a>). The new dose worked but introduced a new problem. One day in the grocery store I bought $100 of lottery scratchers. At first, I was able to manage the urges, but they strengthened over time. One summer I dropped several thousand dollars of a book advance on slot machines. That may or may not sound like much, but consider that I had never seriously gambled before 2007. I crossed a line in 2016, when on a weekend trip, my fianc\u00e9e taught me to play blackjack. I turned $100 into $200, and \u2014 for once \u2014 walked away. It would be the last time that happened. Soon I was losing entire paychecks. I ended up broke, suicidal, and twice hospitalized.<\/p>\n My\u00a0younger brother, Jared, also developed a gambling problem after being diagnosed with RLS in 2007 and was prescribed a dopamine agonist. Unlike me, however, his impulse control disorder emerged almost immediately.<\/p>\n Turns out, both scenarios are common. Where it took me years to go down with blackjack, video poker had my brother by the throat from the get-go. Researchers Howard Weiss and Gregory Pontone put it this way<\/a> in JAMA Internal Medicine: While \u201cthe likelihood of developing an impulse control disorder increases with higher doses of dopamine agonist drugs \u2026 serious impulse control disorders have developed in patients receiving relatively low doses\u201d as well.<\/p>\n Jared was the first to suggest that our gambling might be caused by the medication. I dismissed it. The idea that a prescribed, FDA-approved medication could cause a gambling addiction never crossed\u00a0my\u00a0mind \u2014 and when it finally did, no one believed\u00a0me. Not\u00a0my\u00a0doctor. Not\u00a0my\u00a0psychiatrist. Not even\u00a0my\u00a0pharmacist. One laughed out loud.<\/p>\n Eventually,\u00a0my\u00a0therapist encouraged\u00a0me\u00a0to find a specialist. After weeks of research, I discovered through a Restless Leg Syndrome Foundation<\/a>-sponsored support group that one of the world\u2019s leading RLS doctors, Mark Buchfuhrer, practiced just 30 minutes from\u00a0my\u00a0home.<\/p>\n In February 2021, I drove to his office with\u00a0my\u00a0fianc\u00e9e. I was desperate. I told her I couldn\u2019t marry her while the gambling was an issue. Suicide was never far from\u00a0my\u00a0mind.<\/p>\n Buchfuhrer listened to\u00a0my\u00a0story, nodded, and said, \u201cOnce you stop taking the pramipexole, the gambling will go away in a few days.\u201d<\/p>\n I didn\u2019t believe him. He smiled. \u201cYou\u2019ll be able to stand in a casino and feel nothing,\u201d he said.<\/p>\n When he left the room, I sobbed.<\/p>\n The next day, I stopped the medication. Within a week, the compulsions disappeared. It felt like an evil spirit had been exorcised. Two months later, I\u2019d lost 30 pounds, was eating and sleeping normally, and for the first time in years, I felt clear headed.<\/p>\n And then came the grief.<\/p>\n Because I\u2019d been on the\u00a0drug\u00a0for nearly 20 years, I had to rethink\u00a0my\u00a0entire life through that lens:\u00a0my\u00a0divorce,\u00a0my\u00a0bankruptcy, the end of\u00a0my\u00a0academic career, estrangement from\u00a0my\u00a0children, and a suicide attempt. I wrestled with existential questions of free will and agency. How much of\u00a0my\u00a0life had truly been\u00a0my\u00a0responsibility?<\/p>\n I\u2019m not alone. In an article published in the Mayo Clinic Proceedings, authors (including Buchfuhrer) estimate<\/a> the rate of impulse control disorder among patients who take a dopamine agonist for RLS or Parkinson\u2019s \u201cto be between 6% and 17%.\u201d But while Parkinson\u2019s patients appear to be relatively well-informed about the risk, the vast majority of RLS patients<\/a> are never warned. Even doctors seem to be unaware.<\/p>\n