Reactions 1302 - 22 May 2010

Ropinirole

Skin picking: case reportA 51-year-old man started skin picking, thought to be a

impulse control disorder, during treatment with ropinirolefor Parkinson’s disease.

The man, with a 10-year history of Parkinson’s diseasetreated with levodopa, entacapone, and ropinirole(3 mg/day), was brought to the clinic in February 2008 byhis wife who complained that the man had been ’pickinghis head’ in the few weeks prior to the visit. Ropinirole hadbeen introduced to his regimen in April 2006. The monthbefore presentation his dose was changed from 2 mg/dayto 3 mg/day. Examination revealed five erythematousexcoriated lesions of 4mm diameter and 2mm in depth onthe frontal scalp. He denied any itching or tactile or visualhallucination involving the scalp. He had an ’ON’ score of14/108 in the motor section of the Unified Parkinson’sDisease Rating Scale, was mildly dyskinetic, had pressuredspeech, and hyperactive disorder.

The man was tapered off ropinirole, and after twomonths the man and his wife reported that he had stoppedpicking at his scalp. Hypomania behaviour was alsosuppressed.

Author comment: "Although the patient was on otherpsychoactive medications that may have contributed, the factthat the [skin picking] resolved upon discontinuation of hisdopamine agonist supports the hypothesis that this behaviorcould represent a behavioral side-effect of dopaminergicmedication similar to other [impulse control disorders]"Tse W, et al. Skin picking in Parkinson’s disease: A behavioral side-effect ofdopaminergic treatment?. Psychiatry and Clinical Neurosciences 64: 214, No. 2,Apr 2010. Available from: URL: http://dx.doi.org/10.1111/j.1440-1819.2010.02069.x - USA 803014292

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Reactions 22 May 2010 No. 13020114-9954/10/1302-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved