Fw: [healingparkinsons] Naltrexone for Impulse Control Disorders (ICDs) in Parkinson's Disease

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From: Destiny <destinyellen@...>Subject: [healingparkinsons] Naltrexone for Impulse Control Disorders (ICDs) in Parkinson's Diseasehealingparkinsons Date: Tuesday, January 5, 2010, 8:44 AM

Dear Friends,We are making some headway with naltrexone. This study is normal dose naltrexone, but low dose is probably on the horizon.Have a great day!Destinyhttp://www.michaelj fox.org/research _MJFFfundingPort

folio_searchable AwardedGrants_ 3.cfm?ID= 567Naltrexone for Impulse Control Disorders (ICDs) in Parkinson's Disease

Clinical Intervention Awards 2009

Objective/Rationale :

This is the first controlled trial of an agent to treat impulse

control disorders (ICDs) in Parkinson’s disease. Naltrexone, which

blocks opioid receptors, is FDA-approved for the treatment of alcohol

dependence and has shown benefit for pathological gambling. This makes

it an ideal candidate to explore for the treatment of ICDs in PD. In

addition, naltrexone has been shown to be safe and well-tolerated in PD

patients.

Project Description:

This is an eight-week study in which 48 PD patients diagnosed with

one or more ICDs that developed during PD and in the context of

dopamine agonist (DA) treatment will receive either naltrexone or

placebo treatment in a blinded fashion. The study will be conducted

through the Department of Psychiatry and the Parkinson's Disease and

Movement Disorders Center at the University of Pennsylvania. Patients

will be identified either through screening during routine clinical

care, clinician referral from regional PD centers, or by self-referral.

Recruitment will be such that all four common ICDs in PD (compulsive

gambling, buying, sexual behavior and eating) are equally represented.

Patients will be seen every other week during the course of the study,

and treatment response and tolerability will be assessed at each visit.

Relevance to Diagnosis/Treatment of Parkinson’s Disease:

Up to 15 percent of DA-treated patients experience an ICD at any

given time, with usually pleasurable behaviors becoming uncontrollable

and at sometimes leading to devastating personal, financial or physical

outcomes. Thus, ICDs are a major clinical problem in PD. However, many

patients are reluctant to make changes to their DA treatment, so

patients typically have chronic symptoms. Thus, the clinical management

of these patients is complicated, and additional treatment approaches

are needed.

Anticipated Outcome:

A medication shown to work as a treatment for ICDs with little

impact on PD motor symptoms would allow many ICD patients to safely

continue their DA treatment. This would have significant treatment

implications for the relatively large number of PD patients suffering

from one or more ICDs, who currently have no treatment option other

than to stop or decrease their DA treatment. This would represent a

major advance in the treatment of PD patients. Researchers Weintraub, MDUniversity of Pennsylvania