Evaluation of Nalmefene in Impulse Control Disorders in Parkinson's Disease: A Prospective Open Label Study
Status:
Unknown status
Trial end date:
2018-05-01
Target enrollment:
Participant gender:
Summary
Impulse control disorders (ICDs) (such as pathological gambling, hypersexuality, compulsive
shopping …) are an increasingly recognized psychiatric complications in Parkinson's disease
(PD). Therapeutic management of these disorders is important since they have an impact on
patient quality of life. Dopamine agonists play a key role in the emergence of ICD.
Animal models and imaging underline the implication of opioid system in the genesis of ICD.
An opioid antagonist, the naltrexone, has been studied to treat ICDs in PD. Papay and al 2014
have found that patients treated by naltrexone showed an interesting decrease of their ICDs
measured by the QUIP RScale. Nevertheless, naltrexone has shown adverse effects such as
increasing hepatic liver enzymes. Nalmefene has no known hepatic adverse effects. Nalmefene
is an opioid antagonist that has an antagonist action on μ and δ receptors, but also an
agonist action on κ receptor. Grant and al 2006 has shown significant reduction of the
severity of pathological gambling in patients treated with nalmefene.
The primary purpose is to evaluate the efficacy and the safety of nalmefene in the treatment
of ICDs in PD.