Dopamine agonists and gambling addiction


#1
Recently, I was talking to a PWP with gambling problems due to DAs, I was shocked at the lengths he would go to to gamble, even going without food. I would like to have more insight into this aspect of OCD behaviour.

Aside from the occasional grand national bet and the odd fruit machine I have never gambled at all. It just does not appeal to me. I'm not knocking it as a pastime, Ive even watched racing on TV but never had the desire to place a bet.

So how can it be that someone like me could become addicted to gambling.

I must qualify that although I had OCD behaviour whilst on large amounts of mirapexin I still didnt gamble at all.

How are people who have never placed a bet drawn into gambling? what triggers it?
Similarly people who gambled prior to DAs.What triggers them to go from say a limit of £20 a week to £200,000?

What influences them to place a bet? Is it opening a newspaper at the sport section, the tv advertisements, or just someone talking about racing, or giving a tip.

Is it circumstance, maybe a stressful period sets something off in their heads that makes it happen. Is it hereditary? Several family members were regular gamblers none compulsively so but I never did.

What happens when you stop the DAs?

This is not a thread I can participate in but it would help to give a broader picture of the nature of DA induced OCD behaviour.

Thank you in anticipation of your posts.

#2
Hi Mark,

I haven't opened up much about my gambling addiction, a few people know but I think embarrassment and the fact that I'm ashamed of what I did and I'd sooner forget I did it stops me from talking about it but here goes -

When I was dx in 2004 I was put on Mirapexin more or less straight away, the dose increased over time and Sinemet was added aswell, I can't remember exact doses or dates I never kept a record of them. From the start I had trouble sleeping I'd get at the most 3hrs a night, so I'd read a lot, watch tv, then I started using the pc a lot, I knew that I was experiencing hypersexuality but to be honest that was never a problem for me as it has been for others, my husband benefited from that side effect, now onto the side effect he didn't benefit from " THE GAMBLING", I have to mention that I was NEVER a gambler before PD, although my dad was, he had a gambling addiction for years and used to spend ALL his wages on gambling, mainly horses, leaving my mum and us 5 kids without food, so I had no desire to follow that path having seen what it can do! however that's exactly what I did, I used to play online bingo and the casino games, good fun at first, it gave me something to do through the night, then I started to play more and more, losing more and more, I KNEW it was wrong and I KNEW I should stop but I'd lost that much and I needed to win it back so my hubby wouldn't find out how much debt I'd got us into, he asked me a few times if I was getting addicted and I'm ashamed to say I lied, my neuro asked was I suffering from any OCD's and I said no. I didn't want anyone to know because I knew it was wrong and I felt ashamed of myself.
Now to what stopped me, I had got in too far to get myself out, I'd had my 2 credit cards stopped by the bank, bills weren't getting payed, I was using our visa for food shopping and raiding our money savings tin to buy electricity cards. I had to tell my hubby and although he was upset and angry, he supported me and took charge of sorting out my credit cards and paying bills, trying to mend the mess I got us into.
I stopped gambling, I remained on the DA's, after about another year the mirapexin weren't helping my PD as much as they used to so I was put on Requip xl, 12mg a day, for the first 6mths I thought I was cured then I started to get other health problems, persistent cough, acid reflux, anemia, generally feeling unwell, I'm not sure what was down to the meds but I decided to try living without DA's for a bit, my PD isn't controlled aswell as it was when I was on them but I just wanted to stop all the other ailments I seemed to be getting.
Sorry I've gone of topic!
Not sure what else to say really, I hope I've made sense, if I haven't feel free to ask anything.

Gill.x

#3
Gill

Thank you for being so open.

Opening up can be very cathartic, Its not necessary to go into infinite detail of course. But reading an account such as Gill's can ring bells with people too.

Sometimes its enough to say "yes I had that problem too"

Some may have come to terms with it.

Others may prefer to do it privately to a friend.

Think that last line may be better placed on the hypersexuality thread but you know what I mean. (what hypersexuality thread mark? the one your going to have to set up now instead of going fishing you plonker)

I agree Gill (no need to apologise ) it is off topic.

Maybe someone could set up a seperate thread if they feel the need to do the same as Gill.

#4
Hi Leyther, Hi Gill. Thanks for your frankness, Gill, and well done for getting through that crisis.

Not sure how relevant this is, Leyther, but it may be of interest. The following extracts are from a UK national newspaper 2 years ago:-

"Medical studies suggest that [a significant proportion of] patients taking dopamine agonists develop severe gambling compulsions. People with no history of gambling suddenly become addicts. While most of these people will obsess over slot machines, others will become hooked on internet poker or blackjack. They will squander everything they have on bets that are stacked against them.

"Slot-machine addiction ... reveals a serious flaw in the dopamine system. It's a flaw that is constantly being exploited, from the casino floor to the stock market, and it's ultimately rooted in the way our brain cells make sense of the world.

"A neuroscientist at the University of ... has exposed how the dopamine system works at a molecular level. His experiments follow a simple protocol: he plays a loud tone, waits for a second or two and then squirts a few drops of apple juice into the mouth of a monkey. While the experiment is unfolding he monitors the electrical activity inside individual cells. At first the dopamine neurons fire only when the juice is delivered - the cells are responding to the actual reward. However, once the animal learns that the tone precedes the arrival of juice, the same neurons begin firing at the sound of the tone instead of the reward. He calls these cells “prediction neurons” since they are more concerned with predicting rewards than receiving them. Once this pattern is memorised, the monkey's dopamine neurons become exquisitely sensitive to variations on it. If the cellular predictions are correct, and the reward arrives right on time, then the primates experience a brief surge of dopamine, the pleasure of being right.

"Games of chance prey on this neural system. Think, for instance, about how a slot machine works. You put in a coin and pull the lever. Eventually, the machine settles on its verdict. Since slot machines are programmed to return only about 90 per cent of wagered money, the chances are you lost money. Now think about the slot machine from the perspective of your dopamine neurons. The purpose of these cells is to predict future events. While you are playing the slots, inserting coin after coin, your neurons are struggling to decipher the patterns inside the machine.

"But here's the catch: while dopamine neurons get excited by predictable rewards - they increase their firing when the juice arrives after the loud tone - they get even more excited by surprising ones. The purpose of this dopamine surge is to make the brain pay attention to new, and potentially important, stimuli.

"Most of the time the brain will eventually get over its confused delight. We will figure out which events predict the reward, and our dopamine neurons will stop releasing so much neurotransmitter. The danger of slot machines, however, is that they are inherently unpredictable. Because they use random number generators, there are no patterns to uncover.

"At this point, our dopamine neurons should simply surrender: the slot machine is a waste of mental energy. But this isn't what happens. Instead of getting bored by the haphazard payouts, our dopamine neurons become obsessed. When we pull the lever and get a reward, we experience a rush of pleasure precisely because the reward is so unexpected - the clanging coins are like a surprising squirt of juice. The end result is that we are transfixed by the slot machine, riveted by the fickle nature of its payouts.

"For patients with Parkinson's who are on dopamine agonists, the surprising rewards of the casino trigger a huge release of chemical bliss. Their surviving dopamine neurons are so full of dopamine that the neurotransmitter spills over and pools in the empty spaces between cells. Such patients are so blinded by the pleasures of winning that they slowly lose everything."


Regards,

Ray.
.

#5
Hi Leyther,Gill and Ray,
Firstly,nice to see you are back Ray with your valuable,informative postings,which don't fall on cloth ears:smile:.
Leyther,you seem to be climbing inside my Dopamine boosted mind.First the Rock music,now the gambling.
Gill,your accounts of the troubles you have had are what make those of us at risk,take a step back now and again,realising what can happen.
Now this is the sticking point.Let me put aside the willpower and self control elements that seem to annoy some people.I will just use the term AWARENESS.
I have used this term time and time again.Being a person who has gambled all his adult life and being on DA's.I am totally aware of the problems that could escalate out of control.In all honesty and with all the knowledge gleaned from this forum.If i did develop a serious gambling problem,then i feel i would have only myself to blame.
Before going on DA's my interest in horse racing had diminished along with many other things.Then everything returned,my life and interest in it reappeared.I admit that i now put a bet on daily and look forward to it.Yes,i get a buzz from it.I work on systems and also admit to feeling an obsessional pull.The odd time i have put a little extra on and thought"why did you do that".That's the time when i take stock of how much money i'm putting on and through awareness feel that i am able to continue to bet sensibly.However,being in this high risk scenario,and gambled on horse racing for years,i can understand how people can get carried away.This happens to people in everyday life as it is.I wonder what the percentage figures are for serious gambling problems in normal,everyday life.
Going to study the racing form now.:fearful::smile:
All the best
Titan

#6
Hi titan,

I totally understand what your saying, I agree that gambling addiction happens in everday life, as I said my dad was a gambler and he didn't have PD or take any medication that changed his ways, he just had a gambling problem, however I don't think I would have gambled before taking DA's but who knows, it's happened and I have to move on. As for taking the blame, I take full responsibility for my actions and blamed myself 100% for what I put my hubby and family through!

take care.

Gill.x

#7
Maybe there is a need to look at this issue from a different angle?

Gambling or indeed any of the other OCD's are the symptoms and not the causes. The cause is created when certain brain receptors are being overloaded with dopamine. When this happens it triggers a change in behaviour which you cant control. The trigger point for "Dopamine brain overload" varies from person to person. This is because some people can tolerate dopamine more than other, we would need a whole new thread to go into the reasons for this!

Using the Gambling addiction as an example; When your brain becomes overloaded with dopamine, gambling then becomes the outlet used to fulfil your constant need to seek thrills and take risks. You no longer gamble with any thought of winning or a game plan. You gamble recklessly just to get a "Buzz" and the more risky your gambling becomes, the more Buzzed up you become. Before going on DA's i gambled in the bookies on fruit machines and even the occasional casino visit. However just like titan i stayed in control. I kept to a budget and if i ever gambled more than i had planned too, i was able to question myself and take control. Aged 42 just prior to going on DA's i had no debts, thousands of pounds in savings and was totally in control. Within a year of taking a very high dosage of DA's, i was £300,000 in debt, penniless and shoplifting to fund my gambling. Even the shoplifting used to give me a buzz. I carried on gambling long after my job, money and savings had long gone, but i still needed the thrill and buzz. A typical day back then was; Wake up, wash dress and then spend rest of the morning shoplifting. Then 2 or 3 hours converting the stolen goods in to cash. Off to the bookies with hundreds of pounds i gained from shoplifting. The next couple of hours were spent losing the money in the bookies. When money was gone, it was back to the shops to steal food for my dinner followed by bed ready for the next days outing...... The gambling was by then only the symptom to the real problem, which was my need to take risk in order to seek thrills.

#8
I would like to thank Gill and Blueyes for sharing their experiences. I know from personal experience how hard that is, as I guess most of us are ashamed of our past experiences, even if we were not totally responsible for our actions. It would be really great if we could organize a 'meet' somewhere, as Leyther mentioned in one of his recent posts, we are talking to faceless people at the moment.

I too have my experiences of addictive shopping, the result was that I managed to accrue almost £60,000 worth of debt. Now retired, I am still paying that off from my benefits and I know that until the day I die, those debts will not be paid. Unless a lottery win comes my way of course!!

For what it's worth, I do believe that we need to come together and unitedly take on the medical profession and the drug companies, as the effects of DA's are still being minimized.

Perhaps, as somebody mentioned earlier, we as a group should contact the media and request that a tv documentary be made to highlight the current situation.

Glenchass
Pat

#9
Tremendous insights and brave postings on a difficult subject.

Now that you are off DAs, or at least on a reduced dose, how do you cope.

It seems the media and internet are swamped with advertisements for gambling sites.

Did you find you stopped gambling immediately that the drugs ceased and never gambled again.

If you were a gambler prior to DA's did you return to how you were before.

Has the urge gone completely or does the slightest thing set it off, for instance a web based advertisement.

#10
Hi
in my teens i had a gambleing addiction which led me on a path of destruction but after a few years i was able and curb that.last year when i was going to go on da,s i hestaited big time knowing that these medications can in some people take old.

so i discussed this in depth of my worries with a pd nurse and was asurred at a very low dose i will be okay.any to cut a long storey short ,the effects of wanting to spend money big time and urge to go shopping beyond my means and blow all our money ,i had in to doubt had to off them immediadly.
my new consultant when he found out i had been on da,s and then asked if i had any past addiction ,he was not happy cause this can worsten 20x over when on da,s.

#11
Hi all.

Titan, you say you can understand how people can get carried away, and I agree with you - with regard to normal, non-PD punters. And Gill66, I think your honourable willingness to accept the blame is commendable, but not fair on you - it's NOT your fault, it's the medication.

In the case of non-PwP, including those who are prone to get "carried away", the fault is indeed theirs. But those who are prescribed DAs, and then gamble to ridiculous levels when they never did before, cannot in any way be personally to blame.

As the newspaper article above explains, the non-PD punter will (or should) remain in full contol, since his brain will be acting normally - producing, supplying and utilising dopamine to the exact quantities required for each activity, down to microscopic levels of accuracy.

The PD punter on the other hand starts off with a defective internal dopamine supply chain, and then exacerbates the situation by popping in a 200mg sinemet pill (or whatever) every few hours, and totally swamping the system.

There is no way the brain of such a PwP, with such a messed up dopamine process, would be able to cope with all the mental complexities of trying to solve insoluble random number generation systems. Such a brain would probably go into meltdown, sucking its owner into poverty in the process.

#12
Ray

You obviously have great experience and knowledge of the gambling issue.

However I would disagree with you with regard to non PWP who compulsively gamble. Like alcohol addiction and other drug addictions, compulsive gambling is a well documented OCD problem. One only has to google it to get a plethora of information on this subject.

What I would be interested in Ray, is your own personal account with regard to your gambling addiction on DAs. Particularly as Blueeyes was on cabergoline too.
It would be an interesting comparison of the devastating effects of DAs.

Did you gamble before you took cabergoline?

When you stopped taking cabergoline did all the OCD gambling compulsions cease immediately or over a period. Did any urge to gamble remain?

If you gambled before taking cabergoline but it wasnt a problem when you stopped, were you able to return to the same level of gambling without any problems?

How did you withdraw from the cabergoline? Did you titrate down?

Regards

Mark

#13
Hi again.

Before moving on to gambling I'd first like to discuss the range and sequence of the OCDs which affected me over those 7 years.

I started with one obsession, then gradually added more, until I suffered from maybe 15 simultaneously. Sometimes it was just a case of having (say) three obsessions on the go at once when out of the blue a fourth would join them, with all four having equal prominence in my attentions. On other occasions the new "hobby" would take prominence for a while over the rest, with interest in the previous obsessions temporarily waning. Ultimately they would all return, though, and equalise.

I had no interest in any of them before taking cabergoline. For example my gambling up until then had comprised the Derby, the Grand National and maybe a couple of lottery tickets each year. I actually found betting shops quite unsavoury places, and even the sight of a "massage parlour" would make me cringe. The sequence in which the obsessions entered my life, which has no significance as far as I know, was:-

1. Visual hallucinations;
2. Hypersexuality;
3. Cross dressing;
4. Hardcore web chats;
5. Visiting prostitutes;
6. Excessive and grandiose spending;
7. Compulsive gambling;
8. Excessive generosity;
9. Paranoia;
10. Marital aggression;
11. Violence;
12. Suicidal thoughts/threats;
13. Ebay punding;
14. 24-hour TV quiz channels;
15. Web-based frauds.

In all cases I was very much driven by risk, danger and a powerful desire to "beat the system", as much as the intrinsic pleasure itself.

For example, in the long term you can't beat a random selection system like a horse race, a one-armed bandit or a roulette wheel. As part of your brain's learning process it desperately needs to understand how and why events happen, what the patterns are and when they will occur again. Everything needs to be predictable - in the wild one's life may depend on such expertise.

So in the casino, where one is confronted with a lot of random choices and sequences and no obvious way of knowing what is going to happen next, the brain goes bonkers! The dopamine (if you have enough) explodes across the room! This is nothing to do with winning or losing money (much as that will dominate your life later), it's about excitement, challenge and the brain's desperate need to understand, learn and be able to accurately predict outcomes next time it's confronted by the same situation. The risk of losing large sums of cash which you can't afford just adds to the excitement!

The Oxford headmaster who got caught with 40,000 child porn images on his PC (all acquired whilst on cabergoline) actually said he wasn't really interested in the content, only inasmuch as he knew it was wicked. What really got him going was the high risk, the danger, the chance of getting caught. The judge let him off.

For my own part I spent some time playing the all-night and 24-hour phone-in TV quiz channels - remember those? Although prize money was nice to receive, I was only really interested in beating "the system" - being pretty much able to win on demand, at no cost to me for entry fees or premium phone lines. Once I'd solved that my brain lost interest. The problem could be broken down into several sub components, all of which - unlike roulette - were predictable with enough research and careful observation. It gave my brain a massive buzz when I cracked it, and I won over 100 prizes in 9 months, totalling £26,000.

Finally, when I was into cross dressing (yuk) one of the things I did regularly when the house was empty was dress up in stockings, suspenders, frilly panties, bra, nightie, etc, etc. and then prop the door ajar with a phonebook, say, and go outside when I thought no-one was about. This gave me a double risk: (a) someone might come along and see me like that, and (b) the phonebook might fall over causing the door to slam, stranding me outside the house. My only option then would be to go for help - dressed like that! So I got one buzz from dressing up and another for the risk-taking.

Obviously that scenario now sounds patently absurd, but at the time the risk, the danger, the excitement were unbelievably powerful. Danger ruled my life totally for a long, long time. Once I even - dressed as above - sat in my car IN THE POLICE STATION CAR PARK for an hour or so at about 3am. No-one came, but I wanted to do riskier and riskier things.

Right. Sorry to have gone so wildly off topic, but it's kept me occupied during a sleepless night, and hopefully done a bit to help others get their heads round the complexities of risk & reward, danger, the need for predictability and what creates "highs".

Back to the gambling:

When I stopped taking cabergoline all urges to gamble (or anything else OCD) disappeared within a few days. I do bet occasionally on the horses now, but that's not a compulsion, it's merely because I now feel comfortable in that environment, whereas before it was unfamiliar and I felt like a novice. I spend no more than £10 a week now, including the lottery.

When I returned to my PD clinic with the "evidence" I'd found, I was expecting an argument, but as luck would have it there was a staff shortage, and I was seen by a consultant who specialised in geriatrics, not PD. All of this was therefore new to him and he was shocked to say the least. When I said I wanted to come off the cabergoline immediately he assumed I knew what I was talking about, and agreed. Subsequently the PDNs tried to persuade him to put me back on, at a half measure, and then wean me off slowly, but he pulled rank and I stayed off.

I think I'll go to bed now........

Ray.
.

#14
I have to disagree with you Ray, I take the blame for what I did because I knew what I was doing was wrong and only when it had gone too far and I was in too deep I stopped, I have no desire to gamble again, I had let things get out of control, I'm not saying that the DA's didn't play a part in it, as I said I didn't gamble before but all the time I was gambing I was aware I was doing wrong so in my eyes it was my fault.

#15
Gill:

But don't you think the drugs enhanced the excitement and pleasures you were getting, and increased their desirability, to such an extent that your perception of the importance of "being naughty" altered?

In such a situation, with the adrenaline flowing, you don't realise how the knock-on effects are building up; or if you do, your mindset has wrongly prioritised their significance again.

It then really needs a massive bolt of lightning to jolt you back into the real world. Something like your spouse leaving you, having to remortgage or losing your job might suffice.

Ray.
.

#16
I understand what you mean Ray, but I also understand what Gill is saying too. I knew perfectly well that I couldn't afford to shop or have such expensive holidays as I was doing whilst taking Ropinerole/Requip, however that didn't stop me. I understand the buzz of having something new though and I felt so good. I could spend £100 just in my lunch time, I would put all the bags into the boot of the car and return to work, nobody had any idea. I also would buy people lots of items, it felt so good being able to give things away. There was a definite 'high' feeling, which I wasn't getting from anything else. I took risks with my job and accepted a job in the Isle of Man, leaving my husband here to get on with things. My job ended when I came off the DA's!

Such was my spending spree, that I am now unable to get credit and I am very slowly trying to pay the debt from my pension and benefits. Like you ray I can't get a bank account, however, there is one bank that will accept 'us'. They wont give a cheque book or overdraft but I am able to pay my bills and of course the debts by standing orders ect, if you want the name please contact me.

Glenchass

#17
Hi.

I've signed up with Cashplus Prepaid Mastercard: just Google "Cashplus".

It's a cross between a credit card, a debit card and a savings account. They don't do ANY credit checks, they just want a couple of documents to verify you and your address (e.g. driving licence, utility bill).

You have to put money INTO the account first. Then you can use the card to draw out cash from cashpoints or buy things like you would with a normal Mastercard.

My pension gets paid into it (and when it arrives they send me a text), and I can put cash in at the post office.

However Cashplus will NEVER let you go overdrawn.

Charges:

Monthly subscription £4.95
Cash withdrawal (any amount) £0.99

#18
Glenchass, Gill:

It's a really weird state isn't it? Even if you're "sort of" aware of what you're doing, and that it's wrong, you're floating around zombie-like, in a trance.

The drugs seem to have taken over the controls and left you on autopilot.

In fact it's rather like an airplane hurtling downwards on a trajectory preset by the autopilot, while the captain just twiddles his thumbs and stares vacantly at the controls awaiting his fate.

Was it like that for you? It's impossible to describe to those who've never experienced it, don't you think?

Ray.
.

#19
Hiya Ray, yes it was as you describe it. Even though I knew that there would come a point when I couldn't keep up the payments it just didn't seem to matter, the feeling of being able to buy was the most important thing for me. Actually i probably would have carried on just managing the payments, but I lost my job. At the time I was working on the Isle of Man. I had suspected for some time that my manager was trying to get rid of me, I could see that my pd annoyed her so much. Sometimes whilst I was trying to open a letter and shaking, she would snatch the letter off me and open it then hand it back to me. During my supervision sessions I told her on numerous occasions that she was bullying me. She would apologies but it would simply carry on. She would move the goal posts on me daily and when I met them, she would move them higher until it was almost impossible with pd for me to meet them. I had 4 weeks off sick when they changed my meds...took me off the DA's and when I was due to return to work, she phoned me and told me I was suspended. She said she wasn't able to tell me why and it would be investigated. it took 6 weeks for what she called an independent person to undertake an investigation and I was sacked. The company refused to give me any details of my 'offense' saying it was 'confidential' information. Anyway, I returned to Liverpool, I had to as I was unable to claim any benefits there and the rented accommodation was £1000 per month alone. To cut a long story short, I got legal advice but had to pay for it . It took 2 years for me to fight it and it cost me £12,000 but I won the case for unfair dismissal. That on top of being hounded my debtors almost sent me over the top on many occasions. Sometimes I look back and wonder how the hell I have survived!!

Glenchass

#20
Leyther is right that addictions are just as uncontrolable by 'the will' as someone under the influence of DAs. There is more and more evidence that 'free will' will go the way of the flat earth as an an obvious yet false belief.
http://www.sciencedaily.com/releases/2008/04/080414145705.htm
I have a soft spot for David Hume

No contingency anywhere in the universe; no indifference; no liberty. While we act, we are, at the same time, acted upon. The ultimate Author of all our volitions is the Creator of the world, who first bestowed motion on this immense machine, and placed all beings in that particular position, whence every subsequent event, by an inevitable necessity, must result. Human actions, therefore, either can have no moral turpitude at all, as proceeding from so good a cause; or if they have any turpitude, they must involve our Creator in the same guilt, while he is acknowledged to be their ultimate cause and author. (David Hume, 1737)

David was very very fat so knew about the will. Funnily, when the good people of edinburgh at last put up a statue of the great atheist in the high street, they made him thin.