Pramipexole
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Exercise dependence (first report) in an elderly patient: case report A 66-year-old man with Parkinson’s disease (PD) developed exercise dependence (ED) while receiving pramipexole. The man started receiving pramipexole [starting dosage and route not stated] after being diagnosed with idiopathic PD. Soon after his pramipexole dosage was increased to 3 mg/day, he became obsessed with physical exercise [duration of therapy to reaction onset not stated]. Previously leading a sedentary lifestyle, he started running 20km each morning, followed by spinning training and aerobic fitness sessions. He gradually increased the frequency and time spent exercising each day, reporting a need to exercise to achieve "well-being". He was unaware that this behaviour was unhealthy. When his levels of exercise were reduced, he developed withdrawal symptoms, including irritation and episodes of depression. After 4 months of ED, he developed a severe hypertensive crisis during a spinning session and was hospitalised. Pramipexole was discontinued and the man started receiving levodopa. He had complete resolution of his symptoms and returned to his previous levels of activity. Neuropsychological evaluation upon discharge from hospital revealed his verbal working memory task was severely impaired and a brain MRI revealed minimal diffuse atrophy. Author comment: "[T]he onset of ED appeared to be related to dopamine replacement therapy. Indeed, ED worsened during pramipexole treatment and improved when the drug was discontinued." Vitale C, et al. Exercise dependence induced by pramipexole in Parkinson’s Disease-A Case Report. Movement Disorders 25: 2893-2894, No. 16, 15 Dec 2010. Available from: URL: http://dx.doi.org/10.1002/mds.23323 803048365 Italy
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of exercise dependence associated with pramipexole. The WHO ADR database contained one report of excessive exercise associated with pramipexole.
0114-9954/10/1335-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 22 Jan 2011 No. 1335
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