Aripiprazole is an important medicine for the treatment of
schizophrenia and bipolar disorder. Patients are advised to tell
their doctor if they or their family and friends notice they are
having unusual urges or cravings that they cannot resist,
including behaviours such as addictive gambling, excessive eating
or spending, or an abnormally high sex drive.
Patients should continue taking aripiprazole as advised. Stopping
aripiprazole without medical advice can be harmful.
In the last 14 years, the MHRA’s Yellow Card scheme received 69
reports of gambling or gambling disorder where aripiprazole was
suspected to be the cause. Thirty-two of these reports were
received between 1 January and 31 August this year. In March
2023, the MHRA asked gambling clinics to report any suspected
cases which may account for some of the rise.
Information on these possible side effects have been included in
the Patient Information Leaflet and product information since
2012 (gambling) and 2018 (other impulse control disorders).
Alison Cave, MHRA Chief Safety Officer, said:
The number of reports for suspected gambling and other impulsive
behaviours associated with aripiprazole are small in comparison
to the frequency with which it is prescribed, but the
consequences for any patient developing these conditions can be
significant.
Aripiprazole is an effective and acceptably safe drug for many
people. We are urging all patients to continue to take it and to
speak to your doctor if you have any concerns. Please make sure
you tell your doctor before starting the medicine if you have a
personal history of excessive gambling or any other impulsive
behaviours.
We are highlighting these risks so that you, your family and
friends are aware and can flag to your doctor if you are
developing urges or cravings that are unusual for you. You should
also report them to our Yellow Card
scheme.
The UK reports of suspected addictive gambling occurred in
patients both with and without a history of problem gambling and
most reported that the urges resolved on reducing the dose or
stopping treatment with the drug.
Prof Henrietta Bowden-Jones OBE, Director of the National
Problem Gambling Clinic, said:
Clinicians prescribing Aripiprazole must commit to consistently
alert patients about these potential risks, both during the
initial prescription and follow-up reviews. A significant number
of patients with gambling disorder seen at the National Problem
Gambling Clinic were unaware of the risks as their mental health
teams had not alerted them.
Many had not undergone periodic reviews to assess any new
symptoms of gambling disorder or other compulsive behaviours that
were not present before the prescription started.
As with any medicine, the MHRA keeps the safety and effectiveness
of aripiprazole under close review. Anyone who suspects
they are having a side effect from this medicine is encouraged to
talk to their doctor, pharmacist or nurse and report it directly
to the Yellow Card scheme, either through the website (https://yellowcard.mhra.gov.uk/)
or by searching the Google Play or Apple App stores for MHRA
Yellow Card.
Find out more
Aripiprazole: risk of
pathological gambling DSU
Notes to editors
-
Aripiprazole is approved for the following indications: a)
treatment of schizophrenia in adults and adolescents aged
over 15 years; b) treatment of moderate to severe manic
episodes in bipolar disorder in adults and adolescents aged
13 years and older; c) prevention of a new manic episode in
adults who have experienced predominantly manic episodes and
whose manic episodes previously responded to aripiprazole
treatment.
-
Aripiprazole is part of a class of medicines known as
dopamine agonists. The MHRA has published advice for
healthcare professionals for other medicines in this class
which have similar reported side effects: Dopamine agonists:
pathological gambling, increased libido, and hypersexuality -
GOV.UK (www.gov.uk).
-
More information can be found in the Summary of Product
Characteristics and Patient Information leaflets which are
published on the MHRA
Products website.
-
Aripiprazole was prescribed over 1.5 million times between 1
October 2022 and 30 September 2023 - latest data from
OpenPrescribing. It is
not possible to determine the frequency of these side effects
as a proportion of total prescribing from the currently
available data.
-
For more information on aripiprazole see: Aripiprazole: a
medicine to treat mental health conditions - NHS
(www.nhs.uk)
