Parkinson Disease: Naltrexone May Be Useful For Impulse Control

Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical CenterMedicalResearch.com Interview with:
Daniel Weintraub, M.D.
Associate Professor of Psychiatry and Neurology
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA 19104-2676
Parkinson’s Disease Research, Education and Clinical Center (PADRECC)
Mental Illness Research, Education and Clinical Center (MIRECC)
Philadelphia Veterans Affairs Medical Center

Medical Research: What are the main findings of the study?

Dr. Weintraub: That there is mixed evidence for the efficacy of naltrexone in the treatment of impulse control disorders in Parkinson’s disease, and the evidence is sufficient to support further study of this compound class for this indication.  In addition, the study demonstrates that it is possible to conduct a clinical trial in this area.

Medical Research: Were any of the findings unexpected?

Dr. Weintraub: The only unexpected finding was that the incidence of nausea was higher than anticipated, although it was mild on average.

Medical Research: What should clinicians and patients take away from your report?

Dr. Weintraub: That for those patients who are unable to modify their dopamine agonist treatment to the extent that they no longer have impulse control disorder symptoms, then a treatment trial of naltrexone can be tried.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Weintraub: I think the next step is to conduct a larger, multi-site study with either an opioid antagonist, glutamate modulator, or some other novel compound, using a sensitive rating scale as the primary outcome measure.

Citation:

Naltrexone for impulse control disorders in Parkinson disease: A placebo-controlled study.

Papay K1, Xie SX1, Stern M1, Hurtig H1, Siderowf A1, Duda JE1, Minger J1, Weintraub D2.

2014 Jul 18. pii: 10.1212/WNL.0000000000000729. [Epub ahead of print]

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