Shadow World: Impulsive looks into the lives destroyed by a dopamine drug

Truly, there are some sad stories in Impulsive, the latest series in Radio 4’s excellent Shadow World strand. Steve, whose marriage collapsed when he maxed out his credit cards on cam girls. Lucy, who spent tens of thousands on scratchcards and online gambling. Lisa, who wrecked her relationship with her children when she left her marriage and started having sex with strangers. Bill, who lost upwards of £300,000 to romance scams. Andrew, who was jailed for stealing £600,000 from his clients and whose family was utterly destroyed as a result.

Perhaps these stories don’t seem sad to you: shouldn’t these reprobates have been able to control themselves? To stop gambling, having risky sex, defrauding people? Well, that was the problem. They didn’t know why they started, and they couldn’t stop.

These are just a few of the stories told to Noel Titheradge, an investigative journalist who wrote a piece about dopamine agonist drugs such as ropinirole and pramipexole, and how they can reportedly affect impulse control in some who take them. His article was published a year ago and, says Titheradge, he has never had such a huge response to a story. More than 200 people got in touch, and they’re still emailing him. Some are those who took the drugs, some are their relatives. Often, what they describe is a complete personality change. The sensible teacher, the devout Christian, the steady accountant – all taken over by desires they can’t control, which end up devastating their lives.

For some of them, talking to Titheradge was the first time they had revealed what happened to them. Calm and careful, Titheradge gets those featured on his series to tell their stories honestly, without shame.

There are expert voices: Cambridge University neuropsychiatry professor Valerie Voon explains that dopamine can alter how we balance reward – the high – with the risk of getting it. Titheradge finds a 2003 internal report for the pharmaceutical company GSK, which manufactures ropinirole. It focused on 15 cases of patients who had exhibited “deviant sexual behaviour” while using the drug. One sexually assaulted a seven-year-old and was jailed.

Titheradge acknowledges that dopamine agonist drugs can help those with Parkinson’s (they’re also prescribed for restless leg syndrome and, in a different form, for bipolar disorder and paranoid schizophrenia). GSK did not appear in the series. There is a written statement: “Ropinirol has undergone extensive clinical trials and has been prescribed for more than 7m treatments and subject to three decades of regulatory scrutiny.” It added: “Reports of these side-effects were shared with regulatory authorities in a timely way. While a single adverse event can trigger a review to a medicine’s labelling, a key factor is whether a pattern or trend has started to emerge.” Those whose lives have allegedly been destroyed – partially or completely – by these drugs, deserve better: that is the message heard loud and clear on the podcast.

The warnings about impulse control appear, says Titheradge, in the list of side-effects alongside hiccups, and none of the patients featured had been verbally warned by their doctor. These drugs were prescribed 1.5m times by GPs in England last year alone. Which would be OK, if everyone was clear about these potential adverse effects. “How are these manufacturers getting away with it?” asks one interviewee. Titheradge, in his brilliant series, is the illuminating spotlight that patients need.

Audio Lab is BBC Sounds’ accelerator programme for up-and-coming podcasters and audio creators, and it is a good thing. The MF Doom documentary I recently reviewed came from Adam Batty, one of 2025’s four Audio Lab creators. It’s So Loud in Here!, produced and presented by fellow Audio Lab creator Keira Edwards, is a series that tries to explain how a neurodivergent person is affected by the world around them.

Edwards has autism, and shows how seemingly ambient changes to surroundings – a sudden train announcement, someone switching on the air-con – can be immensely stressful for some. How hard it might be for them to go to sleep, not just because of racing thoughts, but because of their relationship to sound. They might need background noise but not too much, or they’re disturbed by the slightest hum (one interviewee described being kept awake by an electrical buzz from a plug socket that no one else seemed to hear). The noise of a neighbour on the phone, talking at a normal level, might drive them to distraction.

I found this a fascinating counter to those contemporary conversations that assume everyone is either “on the spectrum” or “a bit ADHD”. Edwards is a jolly companion – who every so often tips over into children’s TV presenter levels of enthusiasm – and this is a great series.

I was lucky enough to be invited to a live recording of one of Radio 2’s Piano Room sessions last week. A selection of artists play a piano version of three songs: a new track, one of their well-known numbers, and a cover. Last month’s series has included Pulp, Laufey, Mel C and Mumford and Sons (eclectic!). Tori Amos, resplendent in denim and sky-high heels, somehow managed to play two keyboards at once – a synth and her own grand piano, which she’d brought along to the Maida Vale studios. The BBC Concert Orchestra accompanied, Vernon Kay asked some sweet and revealing questions and the whole thing was lovely.

Everyone, from the musicians to the radio technicians to the inevitable camera operators (audio must be filmed!), all worked seamlessly to ensure that a complicated, in-the-moment musical event could be broadcast as it was happening to millions of people. Not all Piano Rooms are performed live, but those that are have the tension of a high-wire act or an Olympic event. You can feel the pressure in the room, and when everything comes off, it’s a delight.

Photographs by Alamy/BBC