MinervaBMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1585 (Published 20 April 2009) Cite this as: BMJ 2009;338:b1585
Do patients with Parkinson’s disease often become compulsive gamblers or nymphomaniacs? Such extreme behaviours can be provoked by the drugs taken for Parkinson’s, but the frequency with which this occurs and the temporal relation with use of the drugs are unknown. A retrospective study of 267 patients found that seven had documented new onset gambling or hypersexuality. All seven were taking a therapeutic dose of a dopamine agonist. In five of the seven patients the new behaviour was pathological and disabling, and two had been seen by a psychiatrist before the connection with dopamine agonists was recognised (Mayo Clinic Proceedings 2009;84:310-6, doi:10.4065/84.4.310).
Fatal opioid overdoses can be avoided if naloxone is given quickly enough. A US programme, started in 2006, which taught bystanders to administer naloxone as an intranasal spray reports that after 15 months, 74 overdoses had been successfully reversed by 385 bystanders, and that few problems were encountered (American Journal of Public Health 2009;99:788-91, doi:10.2105/AJPH.2008.146647). Minerva assumes that shoving a spray up someone’s unconscious nose without invitation meets with little resistance.
Another potential cause of fatality is long term nasogastric intubation. A case report …