Doctors are required to discuss the risk of impulsive behaviours at review appointments for Parkinson’s patients, who are disproportionately men, under guidelines from the National Institute for Health and Care Excellence (NICE).
But there are no such guidelines for RLS patients, who are mostly women.
“It’s another health scandal where women are sidelined,” says Sally.
Dopamine agonist drugs are also now known to worsen the symptoms of RLS over time.
Some RLS patients describe a cycle where the medications begin working before exacerbating the underlying condition over time.
Doctors sometimes address the problem by increasing dosages, which in turn causes more impulsive behaviour.
Friends and family of patients are less likely to recognise compulsive shopping, according to Valerie Voon, a professor of neuropsychiatry at the University of Cambridge.
She says it’s broadly as common a side effect as compulsive gambling and sexual urges, but those behaviours are typically detected sooner.
“When you’re online shopping, you don’t get feedback very quickly,” Voon says. “You can just order multiple things online and not be that conscious of what you’re doing.
“There isn’t the same kind of stigma attached to it, or socially negative feedback, so it’s likely it can occur for much longer and in a much more hidden manner than some of the other behaviours.”
As a result, Prof Voon says, friends or family can regard the change in behaviour as generosity or extravagance – rather than anything pathological – and so it continues.