advertisement

Aripiprazole Side Effect: Gambling Addiction

April 24, 2023 Natasha Tracy

I had never heard of gambling addiction being a possible side effect of aripiprazole (Abilify) or any other drug. That's why I was shocked to read the headline, "Patients given aripiprazole 'should be told of gambling addiction risks'" in The Guardian.1 I consider The Guardian a source of reliable and fact-checked information, so I looked into it further. It turns out that many people have now recognized that a possible side effect of aripiprazole is gambling addiction.

The Side Effect of Gambling Addiction with Aripiprazole

I believe that when I initially looked up the full prescribing information for aripiprazole, gambling addiction was not mentioned -- I suspect it would have jumped out of me (HealthyPlace has information on medications here.). However, the full prescribing information for aripiprazole now does list "pathological gambling and other compulsive behaviors" as a side effect under the "Warnings or Precautions" section.2 Pathological gambling was noted through post-marking reports. That means that healthcare professionals (or others) reported seeing it as s side effect of aripiprazole after it was approved by the Food and Drug Administration (FDA). (It's important to note

According to The Guardian's article:

The National Problem Gambling Clinic has observed growing numbers of patients who have developed a gambling addiction after starting to take aripiprazole. Some patients have lost huge sums of money as a result and seen their relationships fall apart.

. . . This is not just any side-effect – it can come with a risk of losing your own home. What we constantly see is that not enough people know about this. I gave a recent lecture to all the psychiatrists in my trust and a very large proportion had never heard about it,” she said.

The National Problem Gambling Clinic did an audit of its patients and four that nearly nine percent were taking aripiprazole; yet, they were largely unaware of gambling addiction being a side effect.

In my opinion, that is huge. Almost one-in-10 people seeking help for gambling addiction being on a single medication is just staggering. I realize that thousands and thousands of people take aripiprazole without experiencing that side effect, but as mentioned above, this is not just any side effect; with this side effect, you can lose everything.

How Would Anyone Know About Gambling as a Side Effect of Aripiprazole?

To the maker (Otsuka) 's credit (and yes, probably according to law), they have this listed under important safety information for aripiprazole (capitals theirs):

Some people taking ABILIFY have had unusual urges, such as gambling, binge eating or eating that you cannot control (compulsive), compulsive shopping and sexual urges. If you or your family members notice that you are having unusual urges or behaviors, talk to your healthcare provider.

So, if you went to their website, this information would be clear.

It's also pretty darn clear in the full prescribing information, which elaborates on their "Warnings and Precautions" section and says (bold mine), 

Post-marketing case reports suggest that patients can experience intense urges, particularly for gambling, and the inability to control these urges while taking aripiprazole. Other compulsive urges, reported less frequently, include: sexual urges, shopping, eating or binge eating, and other impulsive or compulsive behaviors. Because patients may not recognize these behaviors as abnormal, it is important for prescribers to ask patients or their caregivers specifically about the development of new or intense gambling urges, compulsive sexual urges, compulsive shopping, binge or compulsive eating, or other urges while being treated with aripiprazole. It should be noted that impulse-control symptoms can be associated with the underlying disorder. In some cases, although not all, urges were reported to have stopped when the dose was reduced or the medication was discontinued. Compulsive behaviors may result in harm to the patient and others if not recognized. Consider dose reduction or stopping the medication if a patient develops such urges.

Were You Ever Asked About Gambling and Aripiprazole?

But here's a question: did your prescriber ever "ask you  or your caregiver about the development of new or intense gambling urges?"

I would wager you didn't get warned before you took the medication, and you weren't asked about it when you were taking the medication. Again, putting the onus on the patient to report even things they have no idea are related to their medication treatment.

So, I guess the long and short of it is two things;

  1. Always report any and all psychological, physiological, and behavioral changes to your doctor. 
  2. Always look up the full drug prescribing information yourself. Doing this through the drug manufacturer's website is easy, but your pharmacist should also be able to provide you with a copy.

Do you have any thoughts about this? Have you experienced unusual urges thanks to a medication? Tell me about it below.

Sources

  1. Hall, R. (2023, March 26). Patients given aripiprazole 'should be told of gambling addiction risks.' The Guardian. https://www.theguardian.com/science/2023/mar/26/patients-given-aripiprazole-should-be-told-gambling-addiction-risks-expert

  2. Full Prescribing Information. (2020, June). Otsuka-us.com. Retrieved April 24, 2023, from https://www.otsuka-us.com/sites/g/files/qhldwo4671/files/media/Abilify-PI.pdf

  3. ABILIFY® (aripiprazole) | Important Safety Information. (n.d.). https://www.abilify.com/important-safety-information.aspx

APA Reference
Tracy, N. (2023, April 24). Aripiprazole Side Effect: Gambling Addiction, HealthyPlace. Retrieved on 2024, June 15 from https://www.healthyplace.com/blogs/breakingbipolar/2023/4/aripiprazole-side-effect-gambling-addiction



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha is also unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, mid-2024.

Find Natasha Tracy on her blog, Bipolar BurbleX, InstagramFacebook, and YouTube.

Cat
May, 25 2023 at 3:43 pm

I have a lot of anger about various side effects from bipolar drugs that were not disclosed to me. Some of them were known, some not. Many of these pdocs were genuinely trying to help me, others were burnt out. I struggle with severe obesity caused by these pills, remembrances of victimization that happened to me while I was on these pills. I have ptsd , from years of akathisia that were literally torture. I think sometimes the pills are worse than the disease, and that's for sure true for those of us who aren't helped, but are seriously harmed. I'm very glad for those patients who do well in treatment. But what about the patients who lost all their savings and their marriage from an induced gambling addiction and they STILL have no good treatment for bipolar?
Natasha, I post here every year or so as a person who is doing mostly ok not on meds. About the same as you, maybe, but with more mania? I don't agree with you on a lot of things.
Thanks for leaving my comments up. I post here because some people never find a treatment, and they need to find a way to live and have some quality of life. It is possible to have a life worth living, even if you're not one of the lucky ones: lithium and done. I'm glad I'm alive. I've been told I have a severe course of bipolar. Somehow I let the bipolar moods burn me and be content, except for the worst months. I'm 60 and there still is no sign of cognitive damage, nor are the moods more chronic. I think some of the meds are doing that to people. My moods did get more chronic due to antidepressants, almost for sure. It's hard to square in my mind that most of the doctors who harmed me so much were trying their best to help me. This happens in other areas of medicine, e.g. chemo, but everyone acknowledges that chemo can harm or even kill the patient, that chemo may not work but the patient is harmed anyway. But people with bipolar are shushed or lied to, often lies of omission, so they'll take their meds. And if meds don't work, what are we supposed to do? The only answer given is you're screwed then. Well that's not true.
Again, thanks for leaving my posts on your site even though I'm often not in agreement, and for tackling difficult topics that are lies of omission elsewhere.

R
May, 13 2023 at 9:55 am

I was told by my Dr that this medication is more “activating” than all the other antipsychotics (it is also one of the more expensive ones as well, - thank God for insurance)). He said he couldn’t give me a traditional antidepressant to help with my depression because there was a likelihood it could cause mania so that’s why this particular medication was prescribed for me. It was considered my best option as antipsychotics are sometimes used as an alternative to the typical “gold standard” (aka lithium which I am unable to tolerate). Antipsychotics can help reduce both mania and psychosis. In the past I have suffered from both when my mania became so severe).
I also tend to obsessively ruminate about things when I am anxious or depressed about something. This can also lead to a variety of obsessive or compulsive behaviours I choose to use in an attempt to relieve my symptoms
I would like to suggest that some people can already have a preexisting proclivity towards obsessive/compulsive thinking and behaviour BEFORE taking this medication and that can manifest itself in any number of ways not just gambling. People are also known to switch addictions when they give up a pre-existing one. It’s possible that a person may also have an undiagnosed or even co existing condition related to obsessive compulsiveness such as an alcohol addiction which is also known to loosen a persons inhibitions and impair their judgement much like a person with a gambling problem - the two can co-exist with one feeding the other. Alcoholics often have a hard time admitting they’re alcoholic or will hide their addiction from others. Many bipolar are also alcoholics (far in excess of 9%)
Depression can also lead to suicide so what’s a person with bipolar (a manic DEPRESSIVE) illness supposed to do???
Even a person already suffering from depression will willingly take a traditional antidepressant even though there is often a warning label on the bottle that says taking this medication may lead to suicide). My question is does it lead to suicidal feelings or is the person already suicidal beforehand and then they just become more depressed and suicidal when they find the medication doesn’t actuall relieve their depression right away or at all. This could lead to a further feeling of hopeless (which is strong contributing factor leading up to suicide)
My guess is that these drug companies are just covering their bases by putting these warning labels on their drug bottles. I don’t blame them. Who wants to get sued? It’s fact is that different people may react differently to different medications for a variety of reasons and we still have much to learn about the brain and the way it works.
Many people with mental illness also suffer economically because of their dis-ease. May I suggest that some people could become compulsive gamblers because of it. Perhaps they feel they’ve run out of viable options to improve their economic situation. Much like gambling, couldn’t filing a lawsuit against a rich drug company also be considered a financial gamble , a desperate persons last ditch attempt to improve their economic situation? After all what do they have to loose, they are already suffering financially

May, 22 2023 at 9:12 am

Hi R,
Much of what you said is true, but keep in mind the gambling addiction issue is of statistical significance -- that's why it was added to the information given out by the drug company. You're right, no one wants to get sued, but that doesn't mean the side effect isn't real.
-- Natasha Tracy

Jennine
April, 25 2023 at 10:37 am

My son lost 10’s of thousands of dollars and 5 years of his life in jail and prison due to robberies committed for gambling money. I don’t believe it was listed in 2017 as a possible side effect.

April, 25 2023 at 12:29 pm

Hi Jennine,
I'm so sorry to hear that. That's tragic. I thank you for sharing that here, though, so other people can know to take this seriously.
I hope you and your son are now well.
-- Natasha Tracy

Leave a reply