increase in mental disorder diagnoses (eg, bipolar disorder, anxiety, depression, and substance abuse) among
patients treated with dopamine agonists, compared with
dopamine agonist-naïve patients. Among patients receiving dopamine agonists, the odds ratio for severe mental
disorder (eg, psychoses and bipolar disorder) was 2. 2,
the odds ratio for moderate to severe mental disorder
(eg, posttraumatic stress disorder and major depression)
was 1. 8, and the odds ratio for mild mental disorder (eg,
anxiety disorders) was 1. 9, compared with dopamine
“This is the first large-scale, real-world, claims-based study to examine the association between
treatment of RLS with dopamine agonists and
the development of psychiatric adverse events.
Our findings are compelling, but need to be replicated in
other patient populations,” said Dr. Hankin.
“Our retrospective analysis required careful con-
sideration of matching,” said Daniel On-Fai Lee, MD,
Clinical Professor of Neurology at the University of
Kentucky College of Medicine in Lexington, who col-
laborated on the study. Although the investigators took
care to match participants and to remove cases of sec-
ondary RLS from the analysis, they may have inad-
vertently overlooked one or more important matching
variables that could affect the outcome, he added.
Arbor Pharmaceuticals provided funding for the study,
but did not influence its methodology, analysis, results,
or conclusion, said Dr. Lee. NR
Sierra M, Carnicella S, Strafella AP, et al. Apathy and impulse control disorders: yin & yang of dopamine dependent behaviors. J Parkinsons Dis.
2015; 5( 3):625-636.
Wilt TJ, MacDonald R, Ouellette J, et al. Pharmacologic therapy for primary
restless legs syndrome: a systematic review and meta-analysis. JAMA
Intern Med. 2013;173( 7):496-505.
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