Pfizer settles lawsuits tying sex and gambling addictions to dopamine meds

Pfizer ($PFE) is settling class-action litigation brought by patients who claimed the drugmaker did not adequately warn them of possible side effects of drugs they were taking to treat their Parkinson’s disease or restless leg syndrome. While this kind of litigation is routine, the side effects were not. Instead patients said the drugs created addictions they didn’t previously have, causing them to gamble away their life savings, or become obsessed with shopping or sex.

The confidential settlement with 172 patients, said to be for millions of dollars, was approved by a judge in federal court in Australia, the Financial Review reports, although payments were delayed until they are assessed by an independent review. Pfizer had agreed to the settlement late last year, ahead of a trial of the cases brought by people who took Pfizer’s Cabaser and Dostinex between 1996 and 2010 to treat tremors associated with Parkinson’s disease or RLS…

The drugs work by providing dopamine agonists that imitate the effects of dopamine in the brain, something Parkinson’s patients lack. A study published last year in JAMA Internal Medicine found that the “psychiatric side effects” of uncontrollable urges were not as rare as first believed. It found the they occurred in at least 10% of patients, but said they probably were underreported because patients were ashamed to talk about what they had done.

The authors of the study said the potential was large enough, greater than suicide risks of antidepressants for example, that the FDA should require a “black box” warning on the labels on dopamine agonists, a class that includes Requip from GlaxoSmithKline ($GSK), UCB’s Neupro and Mirapex from Boehringer Ingelheim. The German company was sued by a New York man some years back who said that taking the drug had turned him into a “pathological gambler,” who ruined him as he gambled away $3 million.

According to the Financial Review Eli Lilly and Aspen Pharmacare also settled with 32 patients in 2013 in similar case involving the drug Permax.

Dopamine Drugs and Possible Side Effects

The reward pathway is a neural network in the middle of the brain that prompts good feelings in response to certain behaviors, such as relieving hunger, quenching thirst or having sex, and it thereby reinforces these evolutionarily important drives. However, the circuit also responds to drugs of abuse, such as heroin, cocaine, amphetamine and nicotine, which seem to hijack the circuitry, altering the behavior of its neurons.

The nucleus accumbens is the engine of the reward response. And, in their study, the UCSF researchers determined that the reward pathway activates pain relief through the release of both opioids, a morphine-like drug produced by the body, and dopamine, a chemical messenger whose effects can be mimicked by amphetamine and cocaine, in this structure. The finding overturns the long-held assumption that the release of dopamine in the nucleus accumbens is associated only with positive experiences…

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