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Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review.
J Psychiatr Pract. 2019 Mar; 25(2):139-145.JP

Abstract

Impulse-control problems such as gambling, increased spending, hypersexuality, and compulsive eating are thought to be influenced by temperamental, genetic, and physiological risk factors. In addition, dopamine receptor agonists have been implicated in some cases. It is postulated that aripiprazole may cause impulse-control problems because it can produce a hyperdopaminergic state in the mesolimbic pathway (reward system) through its predominant action on dopamine D3 receptors. We present the case of a patient with bipolar disorder and previous gambling behavior, in whom the gambling behavior escalated with the introduction of aripiprazole and its upward titration. The patient's gambling problems were alleviated with a decrease in aripiprazole dosage. Clinicians should be vigilant for possible gambling and other impulse-control behaviors in patients taking aripiprazole. Our literature review suggests cariprazine and brexpiprazole, which have mechanisms of action similar to that of aripiprazole, may also be associated with possible risks of impulse-control problems and pathologic gambling.

Authors+Show Affiliations

GIRI: Department of Psychiatry, Psychiatric Neuro Center, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY PETERU: Department of Psychiatry, Consultation and Liaison Services, Jamaica Hospital Medical Center, Richmond Hill, NY.No affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

30849063

Citation

Giri, Yam R., and Sachidanand R. Peteru. "Escalation of Gambling Associated With Aripiprazole: a Case Report and Literature Review." Journal of Psychiatric Practice, vol. 25, no. 2, 2019, pp. 139-145.
Giri YR, Peteru SR. Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review. J Psychiatr Pract. 2019;25(2):139-145.
Giri, Y. R., & Peteru, S. R. (2019). Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review. Journal of Psychiatric Practice, 25(2), 139-145. https://doi.org/10.1097/PRA.0000000000000367
Giri YR, Peteru SR. Escalation of Gambling Associated With Aripiprazole: a Case Report and Literature Review. J Psychiatr Pract. 2019;25(2):139-145. PubMed PMID: 30849063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review. AU - Giri,Yam R, AU - Peteru,Sachidanand R, PY - 2019/3/9/entrez PY - 2019/3/9/pubmed PY - 2020/6/20/medline SP - 139 EP - 145 JF - Journal of psychiatric practice JO - J Psychiatr Pract VL - 25 IS - 2 N2 - Impulse-control problems such as gambling, increased spending, hypersexuality, and compulsive eating are thought to be influenced by temperamental, genetic, and physiological risk factors. In addition, dopamine receptor agonists have been implicated in some cases. It is postulated that aripiprazole may cause impulse-control problems because it can produce a hyperdopaminergic state in the mesolimbic pathway (reward system) through its predominant action on dopamine D3 receptors. We present the case of a patient with bipolar disorder and previous gambling behavior, in whom the gambling behavior escalated with the introduction of aripiprazole and its upward titration. The patient's gambling problems were alleviated with a decrease in aripiprazole dosage. Clinicians should be vigilant for possible gambling and other impulse-control behaviors in patients taking aripiprazole. Our literature review suggests cariprazine and brexpiprazole, which have mechanisms of action similar to that of aripiprazole, may also be associated with possible risks of impulse-control problems and pathologic gambling. SN - 1538-1145 UR - https://www.unboundmedicine.com/medline/citation/30849063/Escalation_of_Gambling_Associated_With_Aripiprazole:_A_Case_Report_and_Literature_Review_ L2 - https://doi.org/10.1097/PRA.0000000000000367 DB - PRIME DP - Unbound Medicine ER -