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Invited Commentary
December 2014

Finding Meaningful Patterns in Adverse Drug Event Reports

Author Affiliations
  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2014;174(12):1934-1935. doi:10.1001/jamainternmed.2014.3270

Apophenia is the perception of meaningful patterns and causal connections among random data. Are case reports of severe impulsive behaviors associated with the use of dopamine receptor agonist drugs examples of apophenia or of a causal connection between the drugs and impulse control disorders?

Parkinson disease, which is characterized by the loss of dopamine-generating cells in the substantia nigra, is often treated with dopamine receptor agonist drugs as a form of replacement therapy. Since 2000, there have been case reports of pathological gambling, hypersexuality, and compulsive shopping in patients treated with dopamine receptor agonist drugs for Parkinson disease and other conditions. An early case report described a 59-year-old woman with a 12-year history of Parkinson disease who had no history of pathological gambling.1 After starting treatment with a dopamine receptor agonist drug, she reportedly began stealing from her family to purchase large numbers of scratch-off tickets and to finance 12-hour days at the casino playing slot machines.

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