A nationwide Swedish case-control study has identified specific pharmacological and psychiatric factors associated with the development of gambling disorder and other impulse control disorders in patients prescribed pramipexole. The research, published in BMC Psychiatry, investigates how treatment duration, dosage, and comorbid conditions influence the risk of these side effects within the Swedish patient population. The study utilized data from the Swedish National Patient Records and National Pharmacological Records to examine the relationship between pramipexole use and the subsequent diagnosis of impulse control disorders.
Pramipexole is a dopamine agonist commonly prescribed for the treatment of restless leg syndrome and Parkinson’s disease. The medication has been linked to gambling disorders and other impulse control disorders developing as a side effect. The primary aim of this investigation was to determine the impact of various pharmacological factors and psychiatric comorbidities on the likelihood of developing these specific side effects.
The study design involved identifying cases where patients had been prescribed pramipexole and were subsequently diagnosed with gambling or another impulse control disorder. The total number of cases identified in this cohort was 189. To ensure a robust comparison, the researchers employed a 3-to-1 matching strategy, accounting for demographic and clinical factors. This methodological approach allowed for a controlled comparison between the cases and matched controls, helping to isolate the specific variables associated with the development of impulse control disorders.
The analysis focused on several key variables, including pramipexole dose, treatment duration, levodopa co-prescription, and the presence of psychiatric comorbidities. These factors were investigated using bivariate analysis and logistic regression models. Additionally, the researchers examined neurological and psychiatric subgroups to identify subgroup-specific risk factors. This comprehensive approach allowed for a detailed examination of how different aspects of treatment and patient history might contribute to the risk of developing impulse control disorders.
The results indicated that longer treatment duration was significantly associated with an increased risk of gambling or another impulse control disorder in the full cohort. The statistical analysis showed a p-value of less than 0.001, with an odds ratio of 1.13 and a 95% confidence interval ranging from 1.05 to 1.22. In contrast, increased pramipexole doses did not show a significant association with the risk, with a p-value of 0.602.
Recent pramipexole therapy was also identified as a significant risk factor. The analysis revealed a p-value of 0.002, with an odds ratio of 2.14 and a 95% confidence interval of 1.32 to 3.48. Furthermore, the presence of mood and anxiety disorders was associated with an increased risk. Mood disorders showed a p-value of less than 0.001 with an odds ratio of 1.98, while anxiety disorders had a p-value of 0.017 and an odds ratio of 1.66.
In the subgroup of patients with Parkinson’s disease, levodopa co-prescription was shown to increase the risk of developing impulse control disorders. This association was demonstrated through Chi-Squared testing, yielding a p-value of 0.046 and a Phi coefficient of 0.15.
The study concludes that pharmacological and psychiatric factors play a significant role in the development of gambling disorder and other impulse control disorders associated with pramipexole use. By identifying these specific risk factors, the research may aid clinicians in identifying at-risk patients and improving the clinical tailoring of pramipexole therapy.
Subject of Research: Association between pramipexole treatment duration and impulse control disorders in a Swedish patient population
Article Title: Gambling disorder and other impulse control disorders associated with pramipexole: a nationwide Swedish case-control study
Article References: Lecerof, M. C., Wolfschlag, M., & Håkansson, A. (2026). Gambling disorder and other impulse control disorders associated with pramipexole: a nationwide Swedish case-control study. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08661-2
Image Credits: AI Generated
DOI: 10.1186/s12888-026-08661-2
Keywords: Pramipexole, Impulse Control Disorders, Gambling Disorder, Swedish Study, Case-Control Study, Dopamine Agonist, Parkinson's Disease, Restless Leg Syndrome, Psychiatric Comorbidities, Pharmacological Risk Factors, Gambling, disorder
News Source: Glenn Wilkins. (November 10, 2026). Swedish Study Links Pramipexole Duration to Impulse Control Disorders. Scienmag.
