Popular Parkinson’s Drug Affects Decision-Making

Elaine Radford - Author

Aug. 23 2017, Updated 4:38 a.m. ET

Levodopa, the most popular drug for Parkinson’s disease (PD), improved the decision-making ability of healthy people over age 70 by making it easier for them to learn from earning a reward. That’s according to a small study from the Wellcome Trust Centre for Neuroimaging in the UK, which performed the tests on a total of 54 people.

What’s new is that the drug was being tested to see if it worked on people who didn’t have PD. Could L-dopa actually speed up an older person’s ability to reach decisions?

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Dr. Rumana Chowdhury, the research team’s leader, explained that the test subjects were given a behavioral test known as the two-armed bandit, which is just what it sounds like — a test that mimics the decisions you make while playing the slots. The players had to pick images that they thought would give them a better chance of winning, and the people who won the most money were assumed to have made better decisions.

If you’ve ever stepped foot in a casino, you can see the problem already. The only good decision you can make when faced with a slot machine is to not sit down. It’s called a random number generator for a reason, people. Winning money doesn’t mean you made a better decision than the other guy. It just means you got lucky.

The thing about Levodopa is that it affects the levels of dopamine in the brain. That’s how it works to slow the progression of Parkinson’s disease in the first place.

And when you change the level of dopamine in the brain, you change behavior. Chowdbury’s study confirmed that.

No quibble there. But is it just me or have we been here before?

Speeding up decision-making so that you respond more quickly to rewards is not a good idea in a gambling environment. It’s a terrible idea. If you respond to the illusion of reward, you’ll get eaten alive.

A slot machine is designed by some reasonably intelligent people to give you just enough rewards to make you keep going. Anything that makes you more responsive to those rewards represents a real and present danger to your financial health.

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Chowdhury said, “The older volunteers who were less able to predict the likelihood of a reward from their decisions, and so performed worst in the task, showed a significant improvement following drug treatment.”

No, no, no, no, nooooo. By “improvement,” the good doctor seemed to mean that the older person reacted faster and made more decisions.

And that’s devastating to the gambler’s bankroll.

Isn’t this just more evidence of what we already know? A major side effect of Levodopa (and other drugs for Parkinson’s disease) is compulsive gambling.

For instance, a Mayo Clinic study found a number of men who became addicted to gambling after being treated for PD with dopamine antagonists.

In a notorious case in 2008, a Minneapolis federal jury awarded $8.2 million to the Charbonneau family, after the dopamine antagonist Mirapex caused the husband, a 68-year-old retired police office, to gamble away hundreds of thousands of dollars. He had not been warned of the side effects.

What Chowdhury considered to be an improvement in the lab can be destructive in the casino. If you make decisions faster, aren’t you sometimes also making them more impulsively?

I’m not Michael J. Fox or Muhammad Ali. If I go off the rails and lose all my money, I’m not gonna get it back by making a few public appearances.

Levodopa is an important tool to fight Parkinson’s disease. But if I was healthy, I wouldn’t risk it to allegedly improve my decision-making skills.

[pill photo courtesy Pðllð and Wikipedia Commons]


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