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Problems? Signs & Symptoms

Problem Gambling: Signs and Symptoms...New information

Brief Overview of Impulse Control Disorders in Parkinson’s Disease

Impulse Control Disorders (ICDs), including compulsive gambling, sexual behavior, buying, and eating, are increasingly recognized as a significant clinical problem in Parkinson’s Disease (PD), occurring in up to 15% of patients. Dopamine agonist (DA) treatment (Mirapex or Requip) is thought to be the primary risk factor for the development of ICDs in PD. In addition to ICDs being relatively common in PD, they often lead to significant impairments in psychosocial functioning, interpersonal relationships, and quality of life, including bankruptcy, divorce, obesity, criminal behavior, and at-risk sexual behavior. Thus, ICDs represent a significant problem in PD.

In spite of the clear association between DA treatment and ICD development in most PD cases, the management of these disorders can be complex. Patients may be reluctant to change their DA treatment due to the motor benefits derived from treatment, so patients often live with chronic ICD symptoms. Thus, the clinical management of these patients is difficult and additional treatment approaches are needed.

The University of Pennsylvania, is working to find a possible treatment for these impulse control problems. They are currently conducting an 8-week double-blind, placebo-controlled trial to test the efficacy and tolerability of a medication called naltrexone for the treatment of ICDs in PD.

The study will assess if naltrexone improves ICD symptoms in PD and is well tolerated. This study is the first controlled trial of an agent to treat ICDs in PD.

This study is being conducted by the University Of Pennsylvania School Of Medicine with Daniel Weintraub, MD, as the Principal Investigator, through support from The Michael J. Fox Foundation for Parkinson's Research. They will be recruiting participants throughout 2010. Participation in this study is voluntary.

For more information on this clinical trial, please go to PDTrials.org and search for Study ID: NCT01052831

UPenn Contact Information:

Kimberly Papay, B.A.

Penn Medicine
kimberly.papay@uphs.upenn.edu
Phone: (215) 349-8390
3615 Chestnut Street
Philadelphia, PA 19104

Daniel Weintraub, M.D.
Penn Medicine
daniel.weintraub@uphs.upenn.edu
Phone: (215) 349-8207
3615 Chestnut Street
Philadelphia, PA 19104

The essential feature of pathological gambling is persistent and recurrent maladaptive gambling behavior that disrupts personal, family and vocational pursuits

Problem gambling may also be identified by answering the questions in the tests that follow.

FOR ADULT GAMBLERS

Lie-Bet Test

  1. Have you ever felt the need to bet more and more money?
  2. Have you ever had to lie to people important to you about how much you gambled?

Answering yes to either of these questions might indicate a problem with gambling

WHAT IS THE STATUS OF YOUR GAMBLING?

  1. Did you ever lose time from work or school due to gambling?
  2. Has gambling ever made your home life unhappy?
  3. Did gambling affect your reputation?
  4. Have you ever felt remorse after gambling?
  5. Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?
  6. Did gambling cause a decrease in your ambition or efficiency?
  7. After losing did you feel you must return as soon as possible and win back your losses?
  8. After a win did you have a strong urge to return and win more?
  9. Did you often gamble until your last dollar was gone?
  10. Did you ever borrow to finance your gambling?
  11. Have you ever sold anything to finance gambling?
  12. Are you reluctant to use “gambling money” for normal expenditures?
  13. Did gambling make you careless of the welfare of yourself and your family?
  14. Did you ever gamble longer than you had planned?
  15. Have you ever gambled to escape worry or trouble?
  16. Have you ever committed, or considered committing, an illegal act to finance gambling?
  17. Did gambling cause you to have difficulty in sleeping?
  18. Do arguments, disappointments or frustrations create within you an urge to gamble?
  19. Did you have an urge to celebrate any good fortune by a few hours of gambling?
  20. Have you ever considered self-destruction as a result of your gambling?

7 OR MORE "YES" ANSWERS WOULD INDICATE A DEFINITE GAMBLING PROBLEM

Related Links

South Oaks Gambling Screen - Self Assessment


FOR YOUNG ADULT GAMBLERS

Lie-Bet Test

  1. Have you ever felt the need to bet more and more money?
  2. Have you ever had to lie to people important to you about how much you gambled?

Answering yes to either of these questions might indicate a problem with gambling

WHAT IS THE STATUS OF YOUR GAMBLING?

  1. Did you ever lose time from work or school due to gambling?
  2. Has gambling ever made your home life unhappy?
  3. Did gambling affect your reputation?
  4. Have you ever felt remorse after gambling?
  5. Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?
  6. Did gambling cause a decrease in your ambition or efficiency?
  7. After losing did you feel you must return as soon as possible and win back your losses?
  8. After a win did you have a strong urge to return and win more?
  9. Did you often gamble until your last dollar was gone?
  10. Did you ever borrow to finance your gambling?
  11. Have you ever sold anything to finance gambling?
  12. Are you reluctant to use “gambling money” for normal expenditures?
  13. Did gambling make you careless of the welfare of yourself and your family?
  14. Did you ever gamble longer than you had planned?
  15. Have you ever gambled to escape worry or trouble?
  16. Have you ever committed, or considered committing, an illegal act to finance gambling?
  17. Did gambling cause you to have difficulty in sleeping?
  18. Do arguments, disappointments or frustrations create within you an urge to gamble?
  19. Did you have an urge to celebrate any good fortune by a few hours of gambling?
  20. Have you ever considered self-destruction as a result of your gambling?

7 OR MORE "YES" ANSWERS WOULD INDICATE A DEFINITE GAMBLING PROBLEM

Related Links

College Gambling


FOR YOUTH GAMBLERS

Lie-Bet Test

  1. Have you ever felt the need to bet more and more money?
  2. Have you ever had to lie to people important to you about how much you gambled?

Answering yes to either of these questions might indicate a problem with gambling

Related Links

South Oaks Gambling Screen - Adolescent Revised
MAGS - Massachusetts Adolescent Gambling Screen
DCGP Youth Gambling Report - 2009


FOR FAMILY

Related Links

Gam Anon 20 Questions