By Dina Harris
My Parkinson’s brain has a crush on shopping. It’s a bit like any adolescent’s crush on a rock star. At 11 o’clock at night there I am in front of the computer in my office. My bleary eyes quite sensibly want to close - but my brain wickedly coaxes them to stay open for “just ten more minutes,” which can sometimes stretch into another hour as I search for bargains. Then I suddenly fall asleep, waking with a terrified start to find the floor looming closer to my nose. My neurologist says, “the brain and the mind are in the same box.” It’s true. And I can usually get them to talk to each other. But not in this situation. This behavior has been increasing, and I know it is chemical, caused by a new type of Parkinson’s medication called an “agonist.” The drug came on the market in 1997. I began taking one in 1998.
A dopamine agonist is a drug which “mimics the effects of the brain chemical dopamine.” Mirapex ® (pramipexole dihydrochloride) is the one I take. It is the first new category of drug for PD to appear since 1969. That’s when Sinemet (synthetic dopamine) first broke the iron grip of paralysis that had made people with Parkinson’s helpless prisoners of their bodies.
Sinemet (carbodopa-levodopa) is still the “gold standard.” But it doesn’t work forever. The more you use, the less effective it becomes. So my taking Mirapex allows me to use less Sinemet-and still be to be able to work, travel and go out on the town with family and friends. My choice to take the agonist is not unlike the choice Hans Christian Anderson’s “Little Mermaid” made. That hopelessly romantic sprite traded in her fish tail for that painful set of legs, so she would be ready to dance with the Prince- in case he ever asked her. I totally get that little half-fish girl.
The side effects of taking this drug can include compulsive behavior. Compulsive gambling often receives media attention, because those who develop this compulsion taking their Parkinson’s drugs often lose house and home, life savings - the works. Compulsive sexual behavior is another documented reaction. By comparison, my dorky crush on shopping sounds pretty respectable! Hasn’t the Bush/Cheney team made shopping a Patriotic Act? (Yuck.) What does it mean, I wonder, that I read only sale catalogues; on-line I only look for bargains? When I can move well - and even when I can’t -I make the rounds of local thrift shops, swap shops, and consignment stores- before I buy the groceries or put gas in the car. If my brain gets harder to talk to about this, will I start to play the slots in a Vegas laundromat instead of breaking the bank at Monte Carlo? Will my wildest sexual fantasy only get a PG Rating?
Is it possible that the mind is talking to the brain after all? What causes some of us on agonists to fly over the cliff - and others of us to somehow resist? I rarely feel virtuous. Am I really that well behaved - even unconsciously?
The solution, after the fact, for the people with PD whose relationships have been ruined or their savings depleted by their response to agonists, is finally to stop taking them; the behavior stops. Only recently, agonist drug manufacturers have started to list compulsive behaviors on their packaging. For now, my mind and I want to keep the choice open. I think we’ll hang in a while longer.
Dina Harris is a playwright who lives on Cape Cod. Last month one of her plays was presented in the tenth Boston Theatre Marathon.
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