Frequently Asked Questions (FAQ) and answers about Abilify, an antipsychotic drug linked to uncontrollable urges to gamble, eat, shop, and have sex.
Frequently Asked Questions (FAQ)
When was Abilify linked to impulse-control disorders?
What FDA safety warnings have been issued for Abilify?
What warnings are on the label?
What are the risks of gambling addiction?
What are some examples?
Abilify® contains aripiprazole, an antipsychotic drug that has been on the market since 2002. It comes in oral and injectable versions sold by Bristol-Myers Squibb and Otsuka Pharmaceuticals.
The FDA has approved Abilify for the treatment of treat schizophrenia, bipolar disorder, major depression, irritability associated with autism, and Tourette’s syndrome. It is also used “off-label” for other mental illnesses.
Abilify is a dopamine partial agonist that balances levels of chemicals in the brain. It increases or decreases dopamine or serotonin depending on whether there is too much or not enough. Similar drugs treat Parkinson’s disease and restless leg syndrome.
Dopamine is involved in the brain’s “reward system.” It is released during pleasurable activities, which reinforces the behavior and produces feelings of motivation to do the activity again. Patients on Abilify may experience intense urges for pleasurable activities. They may not realize the urges or behaviors are unusual.
- Uncontrollable gambling, shopping, eating, or sex
- Stroke in elderly patients with dementia
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Diabetes and weight-gain
- Low blood pressure
- Low white blood cell count (leukopenia)
- Cognitive and motor impairment
Abilify is a dopamine agonist. In 2003, a study found that compulsive gambling occurred in 1.5% of patients with Parkinson’s disease on dopamine agonists. Another study in 2005 by researchers at the Mayo Clinic found 11 cases of gambling addiction, including a 68 year-old man who lost $200,000 in six months. They also reported that the drugs boosted patients’ appetites for sex, food, and alcohol.
In a Safety Communication issued in May 2016, the FDA warned that Abilify was associated with uncontrollable urges to gamble, shop, eat, and have sex. The agency received 184 reports of impulse-control disorders since 2002.
In 2016, the label (PDF) on Abilify was updated with the following warnings:
Post-marketing case reports suggest that patients can experience intense urges, particularly for gambling, and the inability to control these urges while taking [Abilify]. 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 or new or intense gambling urges, compulsive sexual urges, compulsive shopping, binge or compulsive eating, or other urges while being treated with [Abilify]. 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.
Out-of-control betting on lotto, horse races, cards, slot machines, and other games of chance can have a devastating impact on a person’s financial and personal well-being. The consequences of having a gambling problem may include:
- Financial debt
- Home foreclosure
- Loss of employment
- Guilt or emotional trauma
- Damaged reputation
The following case reports of gambling addiction in patients on Abilify were published in the British Journal of Psychiatry in 2011:
- “[J] was pre-occupied with thoughts of gambling and his gambling activity became both impulsive and involved extensive planning in obtaining funds to gamble, including the use of crime.”
- “[K] described an escalation in his gambling to the extent of spending all of his money and it being ‘a reason to live’.”
- “[S] began experiencing strong urges to gamble in the form of a euphoric feeling when thinking about gambling. In the following 2 years he incurred debts of around £25,000 on internet betting sites.”
Hundreds of cases of impulse-control disorders have been linked to Abilify, but only a few dozen lawsuits had been filed as of mid-2016. In October 2016, judges centralized all federal Abilify lawsuits into Multi-District Litigation (MDL No. 2734) in the U.S. District Court for the Northern District of Florida under Judge M. Casey Rodgers.