Medication made dad a sex addict
The Valentine's Day that Peter Ajaka discovered he had Parkinson's disease, he was "a bit of a mess".
Only 50 when diagnosed, Peter - then a council building inspector - had no idea how bad things were about to get.
"I was already shattered," he says. "My symptoms were worsening - my voice became very scratchy and soft; my posture was hunched. I was devastated that day."
Shockingly, the thing that made things catastrophically worse for Peter was actually the medication he was prescribed for the disease's symptoms - known as dopamine agonists.
It came with extraordinary side effects for him - he became heavily addicted to sex and gambling.
Peter takes a deep breath after I ask him the extent of these addictions: "I became an awful person," he says. Then, quieter: "I haven't shared this with many people."
At first, Peter started demanding more sex. "I developed a huge appetite for aggressive sex," he says.
His wife, understandably, didn't want to sleep with him any more. At this point, Peter started visiting brothels three times a week. "I went for the dominant sex I craved," he says.
Simultaneously, he started visiting the casino almost nightly. "I was dropping up to $10,000 a night," says Peter. "Then I'd go upstairs and have domineering sex with one or two women, then come back and gamble. I felt both paranoid and invincible. I didn't realise it was the Parkinson's drug."
In total, Peter, now 60 and living in Belmore, Sydney, gambled away $800,000 by selling his family's investment property - purchased to set him up for retirement and to help his three kids aged 34, 28 and 26.
Cases like Peter's are covered in a new Australian book about how your brain controls your sex life. Sex in the Brain by neuropsychologist Dr Amee Baird discusses similar cases of hypersexuality and gambling addiction as a result of taking dopamine agonists.
But it poses a difficult ethical dilemma: how do you deal with a person who's transformed into a sex and gambling addict because of a drug?
"I do have sympathy for people like Peter," Amee says. "They didn't choose to get Parkinson's - that's a tragedy in itself. They took medication based on advice from doctors then developed these addictions."
As a result of Peter's behaviour, his marriage dissolved. He says his three children no longer speak to him. "I don't see my three grandchildren," he says.
It's something Amee understands - it could sound to those close to Peter like the medication was a scapegoat for his behaviour.
"Of course his wife/kids are angry - it must be hard to recognise it was the medication causing this," she says. "It's a tragedy all round. How it's interpreted needs to be seen through the lens of their relationship prior to Peter taking the medication. It can be difficult to disentangle the person from the drug."
Life before taking the medication was good, Peter says. "I had a good job, a loving and caring wife." Previously, Peter only had a glass of wine or "a nip of scotch with ice" with his evening meal. "I went to drinking a bottle of scotch a day," he says.
Other than an occasional visit to the pokies, he had little interest in gambling. "I had it all - then destroyed it all," he says. "I've lost everything: my family, my friends, my life, my job. I'm ashamed."
Peter had been prescribed a drug called Sifrol by Professor Simon Lewis, Professor of Cognitive Neuroscience at the University of Sydney.
"When the penny dropped it was the medication causing this behaviour, initially I was angry with Simon," Peter says. But he's clear Simon did warn him of these potential side effects to this 'wonder drug'. "It's not his fault. I went from feeling cranky to just feeling depressed," he says.
Speaking to news.com.au, Professor Lewis explained the surprising effect of the drug.
"This phenomenon, broadly classed as impulse control disorders, covers hypersexuality, gambling, excessive shopping, deviant sexual behaviour and hobbyism."
Around 15 per cent of patients taking dopamine agonists will experience an impulse control disorder to some degree, he says.
"It's not hard and fast, but men tend to experience hypersexuality and women tend to experience excessive shopping," adds Professor Lewis.
Another potential side effect of dopamine agonists is remarkable: it can induce same-sex attraction.
Amee Baird's book covers the case of Didier Jambart who in 2012 successfully sued GlaxoSmithKline for 197,000 euros, after claiming that his Parkinson's drug turned him into a gambling and gay sex addict.
"He sold his house, his kids' toys - everything - to fund his gambling," Amee says. "Interestingly, his wife stuck by him through all that. You can see on their faces how distraught they both are. It makes you wonder how much education each patient and their partner is getting from their neurologist."
The court heard that warnings about the side effects of Requip, the drug Didier was taking, were made public in 2006 - three years after he started taking it.
In 2014, drug company Pfizer settled compensation with 160 Australians who took one of their dopamine agonist drugs for Parkinson's and developed new, often devastating gambling and sexual addictions.
In 2011, former Tasmanian MP Terry Martin avoided jail time after being found guilty of having sex with a 12-year-old girl. In his reasoning for giving a suspended sentence, the judge said his offending was directly related to medication for Parkinson's, which caused hypersexual desire. He sought out 162 sex workers, one of which was the 12-year-old.
Amee Baird says these cases pose a challenge for both the criminal justice system and drug manufacturers, adding that the onus is on neurologists to make potential side effects crystal clear.
It's especially complicated because dopamine agonists are widely recognised to be very effective in managing the symptoms of Parkinson's - if you're a patient with those debilitating symptoms, you're likely to be attracted to any wonder drug promising to ease them, and that attraction may overrule your caution.
Jodette Kotz, CEO of Parkinson's Australia, says: "Unfortunately there isn't a huge array of medication available for early onset Parkinson's and dopamine agonists may be the best available for that person - despite these side effects."
Sifrol, the drug Peter took, does list a potential side effect as "compulsive behaviour such as gambling, hypersexuality, shopping, eating, medication use and repetitive purposeless activities" - but it's buried on page 4 and is 23rd in a list of possible side effects under the caveat: "Do not be alarmed by these lists of possible side effects. You may not experience any of them."
But the fact remains: up to 15 per cent of patients will.
Peter is "angry" at the drug makers. "If I knew I'd have any of those problems, I wouldn't have even started taking it. One neurologist wondered why I was even put on it."
A spokesperson for Boehringer Ingelheim, manufacturers of Sifrol, said, "Sifrol has brought significant symptom relief to many Australians living with Parkinson's since its launch in 2008.
"Boehringer Ingelheim was the first pharmaceutical company which proactively requested to add information about reports of abnormal behaviours associated with patients using dopamine agonists.
"It's important that doctors appropriately advise patients and care givers of the potential side effects as clearly listed in the product information."
Ultimately, Peter still blames himself: "I'm more disappointed with myself than anything else. I should've been stronger" he says. "I've made my tragic life very miserable."
Gary Nunn is a freelance writer | @garynunn1
Originally published as Medication made dad a sex addict