Evelyn Pringle February 16, 2006
In mid-2001, Joe Neglia went on a cruise to Alaska and that trip marked the beginning of his downward spiral into hell. The ship had a gambling casino on board and according to Joe, he was "instantly and savagely hooked on the slots."
A major problem arose when he came back ashore. "When I returned from the cruise I began hitting the local casinos," he recalls, "there were three within 25 minutes from my home."
"I hit them every day," he said, "frequently all day for two full years."
The daily gambling binges continued for two full years because that's how long it took for Joe to find out that, Mirapex, the drug he had been taking for Parkinson's disease, had turned him into a compulsive gambler.
Jim Sweet recounts a similar version of basically the same tragic tale. He began taking Mirapex in December of 1998.
"A couple of months later I found myself on my computer a lot," he says, "bidding in auctions on stuff that I didn't need."
Next Jim then turned to gambling online, "running up thousands of dollars in credit card debt."
Like Joe Neglia, Jim never had a gambling problem before taking Mirapex.
As the dosage of the drug was increased, Jim's compulsive behavior increased. Over time, he reveals, "the gambling addiction escalated to include casinos, race track betting, lottery, and more online betting."
"I went through a living hell for over three years while on Mirapex, with a drug induced gambling addiction," he recalls.
For those unfamiliar with this controversy, as remarkable as it may seem, recent studies have shown that Mirapex is indeed the culprit here. On February 15, 2006, United Press International, reported: "Parkinson's disease patients who take anti-tremor drugs are at greater risk of becoming pathological gamblers," based on a study by Duke University and three FDA scientists. The study is discussed in the February 2006, Archives of Neurology.
The patients were drawn from an FDA database of more than 2.5 million adverse drug reports dating back to 1968. The analysis of adverse effects found that the strongest association of gambling was with Mirapex. Five other anti-tremor drugs also showed elevated risks but Mirapex accounted for 58% of the reports.
The study is the second in less than a year to link Mirapex to compulsive gambling and the latest findings are consistent with earlier research conducted over the past several years.
In July 2005, a study conducted at the Mayo Clinic, was published in the Archives of Neurology, and identified 11 Parkinson's patients who developed a compulsive gambling problem while taking Mirapex or similar drugs between 2002 and 2004. Since the study was published, 14 additional patients have been identified with the problem, said Mayo psychiatrist, Dr M Leann Dodd, the lead author of the study.
Although a few patients took similar drugs, Dr Dodd said most of the gamblers were on Mirapex. They included a 68-year-old patient who gambled at casinos and lost more than $200,000 over 6 months, a patient who lost more than $60,000, and a 41-year-old computer programmer who took up gambling on the internet, and lost about $5,000 in a few months. All of the patients stopped gambling within a short time after treatment with the drug was discontinued.
According to Dr Dodd, Mayo Clinic doctors now ask patients on the drugs whether they have taken up gambling. Those patients who have are switched to different drugs or doses, and the result is often dramatic, "like a light switch being turned off when they stopped the drug," Dr Dodd told the Associated Press on July 12, 2005.
Two of the patients who were switched to another drug required additional psychiatric treatment to quit gambling and one patient who withdrew from the program committed suicide after a relapse into gambling.
The study above shows that 1 out of the 11 patients committed suicide due to this problem, but according to Joe, "Most of the reporting on this situation has missed the real story."
"There have been many suicide attempts," he reports, "with God only knows how many of them successful."
"There have been countless bankruptcies, lost businesses, ruined professional careers, emptied retirement accounts," Joe says.
The gambling has devastating effects on families. "There has been a horrible toll in wrecked marriages, personal trust and relationships, and familial estrangement caused by this drug," he reports.
And Joe would know. He was a highly respected government employee trusted to work on intelligence-related issues for 25 years before he retired in 1999.
"I held an extremely responsible position, with a Top Secret clearance, at the Defense Department," Joe recounts, "and this drug turned me into a lying, thieving, duplicitous lout for two full years."
The FDA and drug makers have known about the gambling side effect for years. In the August 2003 issue of Neurology, Dr E Driver-Dunckley, Dr J Samanta, and Dr M Stacey published the results of a study in an article entitled "Pathological gambling associated with dopamine agonist therapy in Parkinson's disease."
That study found extreme cases of compulsive gambling in nine out of 1,884 patients, with 8 using Mirapex and one patient on the drug pergolide, another dopamine agonist drug.
In addition to Parkinson's disease, Mirapex is also prescribed for a condition known as "restless leg syndrome." Dr Jay Van Gerpen, a neurologist and movement disorder specialist from Ochsner Clinic Foundation in New Orleans, told Healthday Reporter at the time, that he wasn't surprised by this study's findings.
"Medicines for Parkinson's disease may elicit unwanted side effects relating to mood and personality," says Van Gerpen. "These medicines are extremely useful, but they may produce unwanted effects. Dopamine agonists can be associated with changes in personality, such as sexual inappropriateness, and changes in sleep cycles. Patients need to be aware of these possibilities," according to Healthday on August 11, 2003.
In August of 2003, the Stacy report hit the news and may have saved Joe Neglia's life. As soon as he learned the cause of his problem, he immediately stopped taking Mirapex and amazingly he stopped gambling within one week.
"I tried to lower the dose," Joe explained, "but the gambling restarted." Next he switched to a different dopamine agonist drug but the gambling started again.
In late February of 2004, he quit all dopamine agonists entirely, and has not gambled one red cent in nearly two years. "There is simply no compulsion to gamble anymore," he says.
"Only upon stopping the drug," Joe says, "did I return to my old, responsible self."
The gambling problem that developed out of nowhere always seemed bizarre to Joe, because from 1977-1980, he was on assignment in England and had easy access to all forms of gambling, including slot machines, and gambling seldom entered his mind.
"I probably gambled all of $20 over the three years I was there," he notes.
Despite studies reporting on this situation from 1999 onward, Joe says the drug makers sit on the sidelines and claim there is no link between the drug and compulsive behavior.
"Their favorite tactic," he reports, "has been to blame Parkinson's disease for this behavior, claiming it's not the drug itself."
"That's baloney," Joe says, "there have been countless cases demonstrating that when use of the drug is stopped, the behavior stops, end of story."
If anything, Joe says the problem is underreported, "because of the embarrassment factor."
Boehringer did revise the warning on the Mirapex package insert in 2005 to include compulsive behavior as a potential side effects claiming it has received "rare" reports since the drug was approved for use by the FDA in 1997.
However, in response to the latest study, the drug maker told UPI, "it was investigating the relationship "if any" between its drug and users developing compulsive behaviors."
Mirapex is one the top-selling Parkinson's drugs. The product had annual sales of approximately $244 million for the twelve months that ended in July 2005, according to sales data from IMS Health, a pharmaceutical information and consulting firm.
How much money did Joe lose? He would rather not dwell on that point. "Lets just say I lost a lot of money," he says. "I am solvent again, but way behind of where I was pre-Mirapex," he adds.
This is where Jim Sweet's story varies a bit from Joe's. After gambling took over Jim's life, he ended up living out of his car most of the time, because he couldn't be trusted at home. "I would pawn any thing of value," Jim reports.
"I was like a drug addict trying to find my next fix," he says. "I didn't want to gamble, I needed to gamble," he adds.
He tried to stop by going to Gamblers Anonymous and counseling and even checked into psychiatric hospitals, but nothing helped.
Finally, at the end of his rope, in the fall of 2002, Jim spoke to a psychiatrist who was obviously familiar with the problem, because he told Jim he suspected a drug induced addiction caused by the Mirapex.
"He took me off the drug," Jim recalls, "and after the drug was out of my system, I stopped gambling."
Just like that, Jim's urge to gamble was gone and he could think straight again.
"It was like a weight being lifted off my brain," Jim says, "I was myself again, able to relax, read a book, watch a movie, and spend time with my family."
Jim lost over three years of his life to Mirapex, and so did his family. "It is only by God's grace that I am here today," he says, "alive with my wife and kids by my side."
In December 2004, Jim and his wife, Kris, got to tell part of their story on Good Morning America. "Right after that airing," Jim says, "Pfizer and BI put out a warning on their product literature, although they buried it on page 17," he adds.
Since getting their own lives in order, Jim and Kris have communicated with hundreds of other people who have gone through the same horrible nightmare.
"I have made it my mission to get the word out and help those that are still in the dark about these devastating side effects of Mirapex," Jim says.
"Now, the drug companies need to make things right by compensating those of us that have suffered so much," he says, "and by putting out warnings of the clear and present dangers of the potential compulsive behavior that Mirapex can cause."
Joe and Jim are both suing the drug makers for failing to adequately warn patients about the gambling side effects.