Finasteride attenuates pathological gambling in patients with Parkinson disease: Comment

Abstract

Presents the case report of 2 patients with Parkinson's disease (PD). Patient 1 was a 65-year-old man, with a 7-year history of PD. Few weeks after the initiation of cabergoline therapy, in addition to his previous regimen with L-dopa/carbidopa, he reportedly felt a growing urge to play cards. After the diagnosis of PG was made, cabergoline was discontinued and replaced with pramipexole and entacapone the patient also began cognitive psychotherapy. He underwent prostatectomy and discontinued prototypical S5aR inhibitor, finasteride (FIN) and tamsulosin. After 2 weeks, he reported a near-complete cessation of PG. This situation remained stable during the following 15 months. Patient 2 who is a 53-year-old man,with a 7-year PD history, reported that his video poker gambling habits had begun 8 months earlier-a few weeks after pramipexole treatment, in the absence of any apparent triggering event. After obtaining informed consent, FIN treatment was initiated. Seven days later, the patient and his spouse reported a marked reduction of PG symptoms. Conclusion drawn suggests that FIN may elicit marked long-term therapeutic effects in PG. The reduction in PG symptoms may reflect the ability of FIN to affect neuro-steroid metabolism.

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