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Letter
Compulsive sexual behaviour in Parkinson’s disease is associated with higher doses of levodopa
  1. Pedro Melo Barbosa1,2,
  2. Talyta Grippe3,
  3. Andrew J Lees1,
  4. Sean O’Sullivan4,
  5. Atbin Djamshidian1,5,
  6. Thomas T Warner1,2
  1. 1 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK
  2. 2 Movement Disorders, National Hospital for Neurology and Neurosurgery, London, UK
  3. 3 Department of Neurology, Faculty of Medicine, Centro Universitário de Brasília, Brasilia, Brazil
  4. 4 Department of Neurology, Bon Secours Hospital, Cork, Ireland
  5. 5 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
  1. Correspondence to Thomas T Warner, Reta Lila Weston Institute of Neurological Studies, Institute of Neurology, University College London, London WC1N1PJ, UK; t.warner{at}ucl.ac.uk

https://doi.org/10.1136/jnnp-2017-317298

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    Introduction

    Previous research estimates the lifetime prevalence of compulsive sexual behaviour (CSB) in individuals with Parkinson’s disease (PD) to be 2.7%. CSB has also been associated with male gender and earlier onset of PD.1 Although both dopamine agonists (DAs) and, to a lesser extent, levodopa have been associated with impulsive compulsive behaviours (ICBs),2 it is still unclear whether higher levodopa doses are a risk factor for the development of CSB in patients with PD.

    Methods

    Patients with ICBs were identified from a database of individuals with PD and ICBs who were seen at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK, and who had participated in three previous research projects over an 8-year period (from 2008 to 2016). All the ICB cases were recruited to research studies from PD clinics at the National Hospital and selected due to the reporting of ICBs. All cases underwent a thorough clinical investigation as well as a detailed semistructured interview conducted by one of the authors. Hospital notes were reviewed by a movement disorder specialist (PMB) for clinical and demographic data. Levodopa equivalent daily dose (LEDD) was calculated according to previously published guidelines.3 Data were analysed using the software SPSS V.24.

    Results

    In total, 128 patients with PD and ICBs were identified. Seventeen cases were excluded because data on dopaminergic treatment when the ICB was most active were incomplete. The remaining 111 patients were included in the analysis. Nearly 75% of the …

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    Footnotes

    • Contributors Study concept and design: PMB, AJL, SOS, AD and TTW. Gathering of data: PMB, TG, SOS and AD. Analysis and interpretation of data: PMB, TG, AJL, SOS, AD and TTW. Drafting of the manuscript: PMB. Critical revision of the manuscript: TG, AJL, SOS, AD and TTW.

    • Competing interests PMB received support to attend academic meetings from Britannia Pharmaceuticals and the Movement Disorders Society and has received a grant from Britannia Pharmaceuticals, also supported by a grant from the Brazilian National Council for Scientific and Technologic Development (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico). AJL is funded by the Reta Lila Weston Institute of Neurological Studies, University College London, Institute of Neurology and reports consultancies for Britannia Pharmaceuticals and BIAL Portela. He also reports grants and/or research support: from the Frances and Renee Hock Fund, and honoraria from Britannia, Profile Pharma, UCB, Roche, Lundbeck, Teva, BIAL, Nordiclnfu Care, NeuroDerm. SOS has received support to attend academic meetings and honorarium from Teva, Lundbeck pharmaceuticals, Eisai, UCB Pharma, AbbVie Pharma. TTW has received support to attend academic meetings from Britannia Pharmaceuticals.

    • Ethics approval Each project received approval from the local research ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.