Impulse control disorders and their relationship with psychopathology in patients treated with cabergoline for hyperprolactinaemia

Purpose: Dopamine agonists (DAs), such as cabergoline (CAB), are first-line treatments for hyperprolactinaemia but have been associated with impulse control disorders (ICD). This observational study aimed to investigate the prevalence, severity, and clinical characteristics of ICD in CAB-treated patients compared with controls, using a combined clinician-administered and multimethod self-report assessment. Methods: A total of 126 participants were included: 63 patients with prolactin-secreting pituitary adenomas receiving cabergoline (CAB) and 63 controls (CG). ICD were evaluated using the Parkinson's Impulse Control Scale (PICS) as the reference diagnostic measure, alongside self-report questionnaires assessing ICD-related behaviors. Psychiatric comorbidity was assessed using the Mini International Neuropsychiatric Interview (MINI), and general psychopathology using the Brief Symptom Inventory-53 (BSI-53). Results: ICD were identified in 15.9% of CAB-treated patients and 6.3% of controls, indicating a more than twofold higher prevalence and greater severity in the CAB group, although differences were not statistically significant. When restricted to CAB-related cases, prevalence decreased to 12.7%. The Questionnaire for Impulsive-Compulsive Disorders (QUIP) showed moderate sensitivity (71.4%) but low positive predictive value (41.7%). Within the CAB group, ICD-positive patients had shorter treatment duration and lower weekly doses. No significant differences emerged in MINI or BSI-53 results, although psychiatric comorbidity was present in ~ 50% of ICD cases. Conclusion: CAB therapy was associated with a modest but clinically meaningful increase in ICD. Screening tools may support early identification, but positive findings require confirmation through comprehensive clinical assessment.

Purpose Dopamine agonists (DAs), such as cabergoline (CAB), are first-line treatments for hyperprolactinaemia but have been associated with impulse control disorders (ICD). This observational study aimed to investigate the prevalence, severity, and clinical characteristics of ICD in CAB-treated patients compared with controls, using a combined clinician-administered and multimethod self-report assessment.Methods A total of 126 participants were included: 63 patients with prolactin-secreting pituitary adenomas receiving cabergoline (CAB) and 63 controls (CG). ICD were evaluated using the Parkinson's Impulse Control Scale (PICS) as the reference diagnostic measure, alongside self-report questionnaires assessing ICD-related behaviors. Psychiatric comorbidity was assessed using the Mini International Neuropsychiatric Interview (MINI), and general psychopathology using the Brief Symptom Inventory-53 (BSI-53).Results ICD were identified in 15.9% of CAB-treated patients and 6.3% of controls, indicating a more than twofold higher prevalence and greater severity in the CAB group, although differences were not statistically significant. When restricted to CAB-related cases, prevalence decreased to 12.7%. The Questionnaire for Impulsive-Compulsive Disorders (QUIP) showed moderate sensitivity (71.4%) but low positive predictive value (41.7%). Within the CAB group, ICD-positive patients had shorter treatment duration and lower weekly doses. No significant differences emerged in MINI or BSI-53 results, although psychiatric comorbidity was present in similar to 50% of ICD cases.Conclusion CAB therapy was associated with a modest but clinically meaningful increase in ICD. Screening tools may support early identification, but positive findings require confirmation through comprehensive clinical assessment.