A 55-year-old man is brought to the physician by his wife because of abnormal behavior. His wife reports he has been preoccupied with gambling at the local casino. He becomes restless and irritable when his wife attempts to restrict his gambling. Four months ago, he was diagnosed with Parkinson disease and treatment was initiated. His only other medical condition is major depressive disorder for which he takes sertraline. The patient does not use tobacco, alcohol, or illicit drugs. Vital signs are within normal limits. Physical examination shows a mild resting hand tremor and minimal rigidity. Which of the following is most likely responsible for this patient's recent change in behavior?

Question

A 55-year-old man is brought to the physician by his wife because of abnormal behavior. His wife reports he has been preoccupied with gambling at the local casino. He becomes restless and irritable when his wife attempts to restrict his gambling. Four months ago, he was diagnosed with Parkinson disease and treatment was initiated.   His only other medical condition is major depressive disorder for which he takes sertraline.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  Physical examination shows a mild resting hand tremor and minimal rigidity.  Which of the following is most likely responsible for this patient's recent change in behavior?

Quizplus · Accepted Answer

Eductional Objective: Dopamine agonist medications used to treat Parkinson disease have been associated with the abrupt onset of impulse control disorders, including pathological gambling, compulsive buying, and compulsive sexual behavior. The behavior is thought to be mediated by stimulation of central dopamine receptors.

A 55-Year-Old Man Is Brought to the Physician by His