Neupro Side Effect--Gambling?

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brevik
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Joined: Sat Jun 04, 2016 3:39 pm

Neupro Side Effect--Gambling?

Post by brevik »

My husband has RLS and sees a neurologist. He took Mirapex for awhile and also Gabapentin but now takes Lyrica twice a day and wears a Neupro patch. He doesn't have the "dancing legs" every night but when he does, he goes for walks to relieve the feeling. In fact, walking seems to be the only remedy if the meds are not effective. If very severe, he takes clonzepan but this just makes him hazy, drowsy, and a bit out of it but it does work sometimes. Instead of wearing one patch a day, he will put another one before the end of the 24 hours. This is not what is prescribed by his doctor but his motto is always take more meds than recommended--more is better in his eyes. I believe his Neupro patches are 4G.

He is a 70 year old Type A personality. His 3 brothers and parents are dead as a result of the negative physical effects of addictions even though they were in and out of recovery mode. Here is my question and concern. I feel he is gambling more and more and is hiding how much he loses and wins. This is a new habit in his life. If I am with him, he doesn't want me to be near him when he is playing slots. I also think he is going to play video gaming machines at our bowling alley. We are both retired but he takes off for hours. He asked me not to look at our credit card charges. I said I wouldn't because I thought he was surprising me with a gift. He has never asked me NOT to look at credit card charges. I looked at the statement and he charged two $200 items for a total of $400 at the bowling alley. This is not like him. We live 60 miles from a casino in a small town and this is the only place video gaming machines are located. I also feel he leaves his cell phone (a flip phone) when he is going to play these games at home so he has the excuse that he didn't answer because it wasn't with him. He also never tells me how much money he has with him when we go to the casino.

We have found this to be somewhat enjoyable as retirees but hiding credit card charges, not telling me about winnings and losses, and visiting video gaming place in our small town has sent up many red flags. In his locked file cabinet, he had $6000 in cash and the next day $1000. I hope he has an answer. Also, he does the finances but now my trust is gone. I am sneaking around which is bothering me but I need some proof.

Is this a real side effect of a Neupro patch? If his doctor takes him off the patch, will his gambling side effect end? Does this compulsive activity not rear its ugly head if he would have adhered to the prescribed dosage? Help? Thanks!

Hopefully, someone can shed any light on this topic. I don't know who to turn to. He is a well-known person in our community and this is blowing my mind that he may be involved in this.

Feeling helpless after being married to this guy for 48 years!

Rustsmith
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Re: Neupro Side Effect--Gambling?

Post by Rustsmith »

One of the side effects of dopamine agonist drugs can be compulsive behaviors. The compulsion can vary from person to person, but gambling, eating, shopping and sex are frequent examples. From what you have described, you need to have a talk with his doctor IMMEDIATELY. His doctor needs to be made aware of this problem. Unacceptable compulsive behaviors can be a side effect that warrants an immediate change in medication. Call tomorrow before your finances are ruined because there have been many cases of these medications destroying family savings, marriages, etc. The compulsions that your husband is likely experiencing are strong and not something that he can control. He may be aware of them, but would have to have an incredibly strong will power to resist, I know because I was also on Neupro at one time (but I am not a gambler). Do a Google search on Neupro side effects and you will find a great deal on this subject.

I believe his Neupro patches are 4G.

My guess is that your husband is currently using a 4mg patch (the box has a big 4 on it). The 3mg patch is normally the largest recommended dose for RLS, but patches are made up to 8mg for use with Parkinsons. Many doctors do not understand that RLS patients should only receive higher doses under very limited situations.

Finally, the reason why your husband is increasing his dose by applying a new patch early may be because he is experiencing augmentation. This is a condition that is unique to RLS patients that are being treating with a dopamine agonist such as Neupro, Requip or Mirapex. After a while, the drug ceases to work and higher and higher doses are required to control the need to move urges. Take a look at the links on augmentation in my signature and in badnight's signature to get a better understanding. Also read the posts in the Augmentation forum. MANY doctors do not know much, if anything, about augmentation and this includes many neurologists. You can download a file on augmentation from the RLS Foundation at http://www.rls.org/about-rls/publications. You might want to share this with his doctor. If he is experiencing augmentation, getting him off of a dopamine drug is going to be very difficult on both of you and will require the support of his doctor. If his doctor does not know anything about treating patients undergoing augmentation, ask him/her to send you to a specialist in RLS who can help (reading some of the discussion threads on augmentation should give you an idea of what may be ahead.

I wish you a lot of luck with what lies ahead. Please feel free to come here as often as you need. We understand and care and are willing to provide as much support (emotional or as information) as you need.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Neupro Side Effect--Gambling?

Post by ViewsAskew »

brevik - so sorry you and your husband are going through this. Steve wrote an excellent reply; hope it helps both of you. Do let us know how we can help.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

badnights
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Re: Neupro Side Effect--Gambling?

Post by badnights »

What you are going through is brutal, and it is devastatingly sad that to end it, you have to go through worse before it gets better. Well, he does, and you have to live with it. But it is very important to start ASAP, becuase things are only going to get worse. Please read Steve's reply carefully and do as he suggests. And move as much of your money as you can into accounts that he can't access. He cannot stop himself - he is not himself - and he will be as devastated as you if he ruins you both.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

brevik
Posts: 10
Joined: Sat Jun 04, 2016 3:39 pm

Re: Neupro Side Effect--Gambling?

Post by brevik »

Thank you! The information is very helpful and before I joined this discussion board, I called his neurologist's office and an appointment has been made. Also, I accessed the links and read about Augmentation and also insights into dopamine agonist meds. On the positive side? He does not know enough about computers to do online gambling. :-) Also, because of the flip phone, he does not gamble using a phone. Trying to look on the bright side. LOL What is difficult now is how to approach or confront him? I will play bridge on Wednesday afternoon and he knows I will be there because we need a set number of players. Again, we are a small town. He can drive by and see my car. This seems to be the time he visits the bowling alley's video gaming machines. But I haven't seen him there because I would never go there. He will not park his car near there because we have a distinctive license plate. My guess he parks near the place and walks in a special door. So my plan is to have a lifelong friend (the only person to know about this) park the car in a lot near the entrance so to see if he walks in but not too close to see the car. Does this sound absolutely nuts? Should I apply for a private detective license? :-) If I don't have some proof of this gaming thing, then how am I going to have solid proof?

Your replies are very valuable as I take this journey. What will be the effects of getting off the Neupro patch and, YES, he has a 4mg. What will this do to his brain? Would this have happened if he stayed true to his dosage instead of overlapping his dosages? He also takes Lyrica in liquid form twice a day. Does this increase the effectiveness or dopamine levels he already has from the patch?

Am I overthinking? Do you think this is an issue? Does it keep getting worse and worse?

Final question or advice for this posting. On Friday morning, he has an appointment with his Ear, Nose, and Throat doctor located in the same town as the casino. My husband had base of tongue cancer in 2010 and had massive doses of chemo and radiation at the same time for 7 weeks. He has no evidence of disease after the 5 years so was released from active care. But my husband told me not to be concerned but he made this appointment because he feels his neck is cramping more than usual. I hope to go with him because I was his caregiver during this terrible time and he credits me (along with the doctors, medical staff, etc.) with keeping him alive with all the meds etc. Normally, we would maybe stop at the casino but I want to tell him no after the appointment. Will this cause a bad reaction? Should I NOT go to the appointment which is 60 miles away but I know he will stop at the casino? When I reread this post, I am shocked this is happening.

Thanks again. I appreciate the support.

ViewsAskew
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Re: Neupro Side Effect--Gambling?

Post by ViewsAskew »

I admire your attitude - it would easy to see it from a slight less positive perspective :-).

I have no experience with what you are going through. My gut tells me to wait until you can stop the meds. Use ANY excuse to stop them; it doens't have to be gambling. If you can talk to the doctor first and explain what is happening and discuss augmentation, you might be able to convince the doc to stop the meds without mentioning the gambling.

Why? Well, I'd normally advocate honestly, but your husband isn't doing this deliberately nor can he stop the impulses in his brain. To override them is asking more than he could do - any of us would be doing as he is. But if you remove the drug, he will most likely just stop on his own and be mortified. Most of the people I've read of in this situation had no trouble at all stopping once the drug was removed.

Per stopping, since he may be augmented, RLS symptoms could intensity during withdrawal. Many doctors will use a strong opioid during this time to counteract this effect. But, since he's taking a benzo - clonazepam - that would have to be monitored carefully. if I remember correctly, the impulse control problem should stop within about a week of stopping the drug.

here are some links that may help you

http://www.psychiatrictimes.com/gamblin ... on-disease

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870289/

http://www.pdf.org/en/science_news/rele ... 1358187216
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Neupro Side Effect--Gambling?

Post by Rustsmith »

I don't feel even remotely qualified to answer your questions on how to confront him or to handle many of the problems that you face. If it were me, I would definitely insist on going with him to the doctor's appointment and then find a reason not to stop at the casino this time. Invite friends to dinner that night or find some other excuse to need to go home immediately after finishing a the doctor. Also just my opinion, I think that your recruitment of a friend to verify your assumptions about the video machines is wise. You need to have something a bit more substantial than your suspicions when you talk with his doctor. A report that a friend saw him at the machines when he knew you were playing bridge should be enough to convince the doctor that this is something more than just a suspicious spouse.

As for what happened with his increased dose, the compulsion problem might have happened to him eventually even if he had not upped the dose. Dopamines are not only involved with controlling the need-to-move part of RLS, but they are also involved with stimulating the pleasure centers of the brain. He appears to have been sensitive enough to the Neupro that it not only controlled his RLS, but the dopamine also started stimulating the gambling pleasure center. The good thing is that the gambling problem goes away very quickly after he gets off of the Neupro (my problems went away almost immediately), assuming that his doctor does not switch him to a different dopamine medication. The bad thing with getting off it will destroy his ability to sleep for a number of days if his doctor is not willing to give him a strong opiate (which you should push very hard to get when you talk with the doctor). If his doctor wants him to go cold turkey on the Neupro (as in no opiates), you are going to need to remove all of the Neupro and any other dopamine medication from the house. He will experience withdrawal that will be similar to what an alcoholic or a drug addict goes through during detox. He will be awake for many hours while you are asleep and no matter how much he buys into getting off of it, there will come a time that he wants (and needs) it so bad that he will search until he finds any Neupro or Mirapex if you have any hidden.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

badnights
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Re: Neupro Side Effect--Gambling?

Post by badnights »

Yes, get evidence.
Yes, go with him to the ENT appointment. I like Steve's idea of creating an event that night that you both have to get home for.

Print the three links Ann gave you regarding the link between DA medications and Impulse Control Disorder. Highlight a few key paragraphs or sentences to direct the doctor's eye to what seems most relevant to you. Also, if you want something specific to WED/RLS, follow the link in my signature and download the Buchfuhrer 2012 paper, or just print this quote from it:

Patients and their families should be
warned as to the potential development of impulse control
disorders [(pathologic gambling, hypersexuality,
compulsive shopping, compulsive eating, compulsive
medication use, and punding)] with dopamine agonists, and they should also be
questioned carefully on follow-up visits because patients
who develop this side effect typically try very hard to
conceal it. Therefore, it is essential that this behavior is
found before it results in large financial losses or the termination
of relationships with spouses, family, or friends. The
impulse control disorder can usually be resolved with a
reduction or elimination of the dopamine drug.
...

Personally, I would share this information with his doctor, as well as information on augmentation. Maybe cut the paper load down to two things - one on augmentation and one on ICD - but keep the other papers in reserve (& leave them with him at the end if you don't haul them out during the discussion). But the key is to express your concern that he is augmenting (if you think he is) and that he has ICD from the DA.

The hard part will be deciding whether or not to tell your husband what you have learned; how or whether to provide him with the same information so he can learn about it too. Do you speak to his doctor with him there, or absent. These decisions you will have to make.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

brevik
Posts: 10
Joined: Sat Jun 04, 2016 3:39 pm

Re: Neupro Side Effect--Gambling?

Post by brevik »

Thanks once again for all of the information. Today I play bridge. Today my friend will be sitting in a parking lot looking for my husband to walk in. I HATE that I have to be a super sleuth or senior citizen Nancy Drew but things just aren't right. On suspect he went someplace on Sunday because when he returned, he was almost like on a high of some sort. He said he was going to do somethings but when I asked him about it, he was very vague. The guy must be a little nuts right now because the Cubs are being broadcast today and if I was a betting person (poor pun intended!!), he will not be home to watch them. I also have checked into Quality Care Centers in the USA. I live in west-central Illinois, 4 hours from Chicago and 3 from St. Louis. But I called the neurologist yesterday and are scheduled to drive an hour on June 20th for an appointment. He does not know about this yet. Been told I need to look and bring all Neupro patches with so that he cannot find them so he can't administer them.

Our youngest son is visiting us over the Father's Day weekend and while not going into a lot of details, he knows what is happening. He suggested the two us do a humorous and easy-going intervention while he is here. I think this will happen.

I also talked to the staff at the doctor's office about augmentation; I am reassured that he is well-informed. I will print out the info on the links--THANKS for posting them.

I am also encouraged that the gambling urge will cease after a week and that he does not have to go to rehab or GA meetings. We have both been attendees at Al-Anon meetings in past years because of family additions.

In our town there are 9 establishments with VGMs. However, 4 are veterans places where he will not go. Two are open at 11 and one at 1. Hopefully I will have concrete evidence that he is going there or am I back to square one?

My stomach is in knots all the time.

Thank you very much for responding. I set up this email only for the RLS Org. responses.

ViewsAskew
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Re: Neupro Side Effect--Gambling?

Post by ViewsAskew »

We all wish you well. None of us has dealt with this. So glad your son is involved - that must make you feel much better. Do let us know what happens.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

brevik
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Re: Neupro Side Effect--Gambling?

Post by brevik »

Good Morning!
Yesterday was an interesting day in my almost 48 years of marriage and knowing this guy since April 1967 when we were in college. My friend parked her car near a lot of the bowling alley and watched for my husband to enter the building. I was at bridge and my car was visible to him if he drove by to see if I were actually there. Now in my town, we can get from one side of the town in about 8 minutes. The friend was going to leave after sitting there for 1 hour and did. BUT, she checked out two more places that have VGMs. The first place--No. The second place--YES. I don't know how I feel about this. First, I have proof of where he was after he has continuously lied about his whereabouts. Also my friend took photos of the car in the lot (hey, only 3 were there) and we are both surprised at his boldness to park his car right by the place instead of a nearby lot--silly guy. He has no clue that Nancy Drew Super Sleuth senior citizen and her sidekick are so clever. Second, I am shook-up and shaky that what I have suspected strongly is true. Oh my.....

This discussion board is so helpful. I am a retired college English teacher; writing can be so cathartic. Thanks for reading my ramblings.

Called the doctor's office and no openings next week but there may be a cancellation.

Talking to our retired family physician today who has helped our family in the past when discussing addictions. Also, I may reach out to a person in our college's counseling center.

The plan is to buy a safe so that once there is a confrontation of sorts on June 18th when our youngest son is here, I can hide all checkbooks, savings accounts, and other paper items. Also, I have been searching all the Neurpro places he keeps them.

Neurologist on Monday, June 20th.

Not the way I want to spend Father's Day weekend and our son will be there for moral support.

Thanks again for reading. Once again, please offer any words, advice, etc.

Rustsmith
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Re: Neupro Side Effect--Gambling?

Post by Rustsmith »

I have really mixed feelings about all of this, but not in the normal terms of that expression.

On the one hand, it makes me very sad that you, your husband and your family are having to go through this. Of all the side effects of the dopamine agonists, this is perhaps the worst. I am also sad that it appears that your suspicions were correct.

But I am also happy for you for a number of reasons. First, because you knew enough to suspect that this was going on and were able to catch it before it really got out of hand. If it had gone on for another couple of months, the results could have been so much worse. I am also happy about the fact that you have been able to find the resources to develop your plan, educate your self and were able to recruit so many friends to help you. I shudder to think of how this might have eventually turned out if you had been in a position that required you to handle everything by yourself.

Finally, I am happy that you have found the strength to be able to get through to this point, to deal with it in the way that you have and that you realize that it is the Neupro and not the guy that you married who is responsible for all of this.

So, I think that I can speak for everyone here that out prayers and best wishes are with you during this next week, and beyond.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
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Re: Neupro Side Effect--Gambling?

Post by stjohnh »

Rustsmith wrote:....
So, I think that I can speak for everyone here that out prayers and best wishes are with you during this next week, and beyond.


Me too.
Blessings,
Holland

ViewsAskew
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Re: Neupro Side Effect--Gambling?

Post by ViewsAskew »

My family has our fair share of addicts. I can remember one particularly difficult and emotional confrontation about addiction that led to a gun being pointed...it was one of the scariest moments of my life.

Our brains and their reward system can cause incredible problems and difficulties. What likely seemed like a great thing to ensure we would not starve and would want to procreate has a dark side to it that can be the cause of incredible distress.

I don't know your husband...I do know what people can do to protect something they want dearly. Please keep yourself safe and work with your family, friends, and advisors to think of ways to ensure nothing more than words are hurled about. Do whatever you can to make sure that you are protected from any possible retaliation or lashing out however you decide to confront him. From what I've read, your husband will likely feel humiliated and ashamed in a few days - after it starts to wear off. Until then, he likely will want to protect his source however he can.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Polar Bear
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Re: Neupro Side Effect--Gambling?

Post by Polar Bear »

As ViewsAskew has said - please keep safe.
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

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