(this is waaaay too long - sorry!)

anuket *has* been there, done that:

http://anukets-crusade.blogspot.com/2007/02/gambling-parkinsons-meds-just-read.html
scroll down to:
COMPULSIVE BEHAVIOR CAN OCCUR WHILE ON A DA BUT BE UNRELATED

“For part of the six years I have been taking a DA, I got a little too much pleasure out of shopping – but it could not have been classified as a side effect of the drug by any of the standards of measure used by any of the studies I plan to dissect. I was depressed (due to circumstances in my life for the most part unrelated to Parkinson’s) plain and simple, and that is what the onset and resolution of the behavior corresponded with, temporally speaking – it did not correspond with initiation of the drug or any dosage change (there has been no dosage change in almost six years.)”

so, you see, it is entirely possible for compulsive behavior to develop while one is taking a drug and not be related to that drug. It is particularly interesting that pathological gambling is highly associated with depression, which, as we all know, is rampant and Parkinson's.

moreover, the onset of the behavior in question is always said to occur in conjunction with either the initiation of therapy or an increase in dosage. What causes the need for initiation of therapy on increasing dosage? The worsening of symptoms creates the need for initiation or an increase in dosage -- I don't know about anyone else but I find that moment quite depressing!

This all goes to your point Lindy, as do inevitable omissions like the fact that 90% ( that is an educated guess) of the people who gambled on a dopamine agonist were also taking levodopa.

I wish that, just once, someone who believes this drug is responsible for this behavior would address even one of the points that anuket makes, or one of her criticisms of one of the studies – because that is what she is taking issue with – the validity of the studies – not with anyone’s personal experience.

but no one ever has, I don't think, at least I have never witnessed it.

these studies are not rocket science - there are no unfamiliar terms like mglur4 or sonic hedgehog or autophagy - the language and the concepts are understandable to the lay person.

and the caliber of flaw is on the level of claiming to have found a causal association based on having found 11 people who experienced this phenomenon while taking an agonist - that is it, just 11 - no mention of 11 out of *how many.* was it 11 out of 11? or was it 11 out of 1,000,000? no special training needed to see that without that piece if information, the claim of a causal association is completely unsupported, not to mention irresponsible and unethical.

and that study was published in a peer-reviewed journal, so, so much for peer review.

in the studies that do put forward a prevalence, that number has been climbing steadily since the first study in 2003, which claimed to find a then-alarming prevalence of 1.5%. Six years later, they are claiming a whopping 20% prevalence and calling it an underestimate. where will it stop? how high will that number go? If goes up to 25%, will it be questioned? What about 35%? 50%?

This is not without cost to pwp in general.

at an alleged 20% prevalence, and with the relentless publicity this has gotten since 2003, it is reaching the point at which the general public is aware of, and believes, it. i, personally, have already had comments suggesting i might be engaging in or vulnerable to of compulsive behavior directed at me. Of course, *we* know that the 20% applies only to those taking agonists, but i guarantee you that that distinction is lost on the general public, so welcome to the world of being viewed as a hypersexual pathological gambler waiting to happen, everyone.

All of which would be unfortunate but unavoidable if 20% (or more) of pwp taking agonist were experiencing such a phenomenon.

I don’t think they are. And I don’t think the prevalence estimate will stop its upward climb at 20%. Why? between 1966 and 2002 about 2.4 studies per year containing the words compulsive and Parkinson’s were published. between 2003 and 2009, 28 studies per year containing the words compulsive and Parkinson’s were published. Call me cynical, but this is not without benefit to the people doing these studies.

I have read the studies anuket questions in her blog, and I have found her facts to be accurate. I think an estimate of 20% prevalence should make everyone question – that is HUGE.

I know that at least five of these gambling studies do not support their conclusions. I think this is getting to the point at which it is damaging to pwp in general. And I implore anyone and everyone with an interest and the time NOT to just believe (or not) me or anuket but to read at least one of those five – two of them are available for free at:

http://www.ncbi.nlm.nih.gov/pmc/issues/177782/
and
http://archneur.ama-assn.org/cgi/reprint/62/9/1377?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&full text=dodd&searchid=1&FIRSTINDEX=0&resourcetype=HWC IT

Or, if you have read a study that you think that supported its conclusions, I would love to read it.