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New study links increased risk of impulse control disorders to dopamine treatment

UK study suggests that patients with prolactinoma treated with dopamine agonists are more likely to develop impulse control disorders

18 June 2025
Man holding a pen points at screen displaying MRI brain scans

Patients with the most common form of tumours affecting the pituitary gland, located at the base of the brain, are more likely to develop impulse control disorders as a side effect of a drug called a dopamine agonist, new research suggests.

The new study, published in The National Library of Medicine, is the first of its kind to investigate a cross-sectional sample of patients within the UK.

A research team, led by Professor Niki Karavitaki with post-graduate students Dr Ross Hamblin and Dr Athanasios Fountas, from the University of Birmingham assessed the prevalence of impulse control disorders in a study of adults with various types of pituitary tumours in a pituitary centre.

Patients with prolactinoma, acromegaly or non-functioning pituitary adenoma (NFPA) were reviewed where they were either treated or not with DAs using two clinical tools.

Among the 200 patients studied, the team found that those with prolactinomas, the most common form of pituitary tumours, showed a significantly higher prevalence of impulse control disorders when treated with DAs compared to patients with non-functioning pituitary adenomas (NFPAs).

Impulse control disorders encompass a group of behaviours defined by an inability to resist an impulse to perform an act considered to be harmful to an individual or others. Common examples include hypersexuality, compulsive eating, gambling or buying, but can also include more unusual behaviours such as hobbyism or punding (repetitive and purposeless behaviours).

Our main recommendation is that clinicians and GPs should be proactively aware of the risk surrounding those on dopamine agonists developing impulse control disorders and consider how best to keep patients and their family members informed throughout treatment.

Professor Niki Karavitaki, senior author

Professor Niki Karavitaki, the senior author of the study, explains:

“We found that patients with prolactinomas treated with dopamine agonists (DAs) were more likely to show manifestations of impulse control disorders, compared to those with non-functioning pituitary adenomas (NFPAs) who weren’t treated with DAs.

“Our main recommendation is that clinicians and GPs should be proactively aware of the risk surrounding those on DAs developing impulse control disorders and consider how best to keep patients and their family members informed throughout treatment. Impulse control disorders can have a profound impact and consequences for those who develop them, so patients must be fully aware of this before beginning integrated treatment programmes.”

Despite the risk of developing an impulse control disorder being a growing cause for concern, it’s still a valuable form of treatment for many patients with pituitary adenomas. Alternative treatments - such as surgery or radiotherapy - also carry a range of risks and side effects, hence the need to consider further research on the most optimal and personalised management approaches.

Professor Niki Karavitaki added:

“If a prolactinoma remains without treatment, patients may experience a wide range of other consequences, including fertility issues and hypogonadism, which can lead to other long-term health issues such as osteoporosis, a higher cardiovascular risk or even increased risk of tumour growth.

“Whilst the aim of this study was to raise awareness around the increased likelihood of some patients on DAs developing impulse control disorders, it’s still an extremely important form of treatment that benefits many individuals. We hope that our findings will help to enhance awareness of the risks related to the use of DAs and pave the way for more nuanced studies investigating the efficacy and safety of other management options, too.”

Notes for editors

For media enquiries please contact Holly Young, Press Office, University of Birmingham, tel: +44 (0)7815 607 157.

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Featured staff

  • Professor Niki Karavitaki

    Professor of Endocrinology

    School of Medical Sciences

    Staff profile of Professor Niki Karavitaki, Professor of Endocrinology at the Department of Metabolism and Systems Science, University of Birmingham

    Phone: +44 (0)121 415 8715
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