Dopamine agonist induced adverse effects

These include:

• nausea
• dizziness and postural hypotension
• these adverse effects are dose-related - they can be limited by increasing the dose slowly and often reduce with continued therapy

Other side effects include:

• neuropsychiatric toxicity e.g. vivid dreams, hallucinations, hypersexuality, delusions - often associated with paranoia, confusion
• neuropsychiatric toxicity is commoner in older patients, those with underly cognitive deficits, those who have suffered neuropsychiatric adverse reactions from other antiparkinsonian medication; also these side effects are more common when other antiparkinsonian medication and dopamine agonists are used concomitantly
• neuropsychiatric side effects are not strongly dose - related; however reduction of the dose of dopamine agonist sometimes improves neuropsychiatric toxicity but may result in aggravation of parkinsonism. A reduction in the dose of other antiparkinsonian drugs, especially anticholinergics, may help
• uncommon idiosyncratic side-effects include inflammatory pleuro-pulmonary disease

Treatment with dopamine-receptor agonists is also associated with impulse control disorders, including pathological gambling, binge eating, and hypersexuality. Patients and their carers should be informed about the risk of impulse control disorders.