Introduction Dopamine agonists are associated with impulse control disorders (ICDs) such as reward based, compulsive actions, medication use and punding. In clinical practice these are relatively common and potentially have devastating psychosocial consequences. As the license of dopamine agonists extends to other conditions such as restless leg syndrome (RLS) we audited our clinical practice of the advice given to patients.
Methods A retrospective audit of 24 case notes was performed using SIGN guidelines.
Results 18 were on dopamine agonists, and advice was documented in four cases (22%). Sixteen had PD of which 12 were taking dopamine agonists (75%); three were told to inform the DVLA (18.8%), one was given ICD advice (8.3%), and one was informed of postural hypotension and drowsiness (8.3%). Seven patients were also seen by the PD specialist nurse and all were informed of ICDs. Eight patients had RLS (two had MS); six were on dopamine agonists (75%), and ICD advice was documented in one patient (16.7%).
Conclusion We readily prescribe dopamine agonists, however our information giving practices are deficient and do not meet recommended guidelines. Patients therefore are poorly informed, potentially unaware and are unknowingly being put at risk. We must discuss potential side-effects, document it in the medical notes and outline it in the GP letter. This discussion might be reinforced by sending a copy of the clinic letter to the patient and by referring patients to a PD specialist nurse.
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