Abilify and Compulsive Gambling

Reviewed by Eric Patterson, LPC

Key points:

• Abilify and Impulsive Behaviors: Abilify (aripiprazole), an atypical antipsychotic medication, has been linked to impulsive behaviors, including gambling addiction. This can also extend to compulsive urges to binge eat, shop, and have sex. The impulsive behaviors often subside after lowering the dose or stopping the medication, though professional guidance is advised.

• Handling and Treating Compulsive Gambling: If compulsive gambling occurs after starting Abilify or a similar medication, consulting a healthcare professional is crucial to evaluate and address the issue.

Yes, according to the FDA, in some cases, the drug Abilify (aripiprazole) causes impulsive behaviors such as gambling. Abilify also results in compulsive urges to binge eat, shop, and have sex. In most cases, lowering the dose or stopping the drug completely curbs these behaviors. However, there may be larger issues at play that need to be addressed by a professional. Although this increase in gambling could be worrisome, it is different than a gambling disorder, which is a fully separate mental health condition.

In the cases where patients report having urges of compulsive gambling, the behavior occurs within days to weeks of beginning to take aripiprazole. These patients have no prior history of gambling, and the behavior is tied to the medication Abilify. Fortunately, in many of these cases, gambling disorder subsides and ceases shortly after cessation of the drug.

Facts about Aripiprazole (Abilify, Abilify Maintena, Aristada)

Abilify is a brand name of aripiprazole. It is also sold under the brand names Aristada, Abilify Maintena, and others. Aripiprazole is an atypical antipsychotic used to treat major depressive disorder, Bipolar 1, schizophrenia, Tourette’s, and irritability in autistic patients.

The mechanism by which Abilify may contribute to compulsive behaviors, such as gambling, is not yet fully understood. However, it is believed that the medication's impact on certain neurotransmitters, particularly dopamine, plays a role. Dopamine is a chemical in the brain associated with pleasure, reward, and motivation, and abnormalities in its regulation have been linked to addictive behaviors.

As a result of the connection between Abilify and gambling, multiple class action lawsuits have been filed against the makers of Abilify. These lawsuits focus on the manufacturer's failure to warn patients of the side effect of compulsive gambling.

Despite these potential side effects, Abilify is still prescribed and crucial to the treatment of certain populations. However, it is necessary to remain vigilant against side effects that can cause harm to the individuals taking the medication and their families and friends.

Can Other Medications Cause Gambling Addiction?

Abilify may not be the only drug linked to occurrences of impulsive gambling. A study in Italy linked 94 suspected cases of compulsive gambling to drugs like, apomorphine, aripiprazole, cabergoline, levodopa, levodopa and derivatives in association with entacapone/benserazide and carbidopa, pergolide, pramipexole, ropinirole, and rotigotine.

It is understood that dopamine agonists can result in behavioral disorders. If compulsive gambling occurs shortly after beginning a new medication, you should consult your doctor immediately to determine if gambling is a side effect of the new medication.

What are the symptoms of compulsive gambling?

Compulsive gambling, also called gambling disorder, is on the rise according to some reports. In the modern era, gambling has become more accessible. These days, gambling doesn't just occur at casinos. Gambling can happen online with a computer or phone. And gambling isn't just poker or slots; it can be lottery tickets known as scratchers, risky day trading, or involvement with crypto. Sports betting sites are popping up all the time.

With the advent of new technologies, anonymity, and constant access, gambling disorders may be easier to hide than ever. With that in mind, it is necessary to stay vigilant and take note of any behaviors that may fall under a gambling disorder.

If you suspect somebody may be developing a gambling disorder, whether or not it is linked to Abilify or similar drugs, there are some key signs to look for. These signs include:

• Increasing preoccupation with gambling, constantly thinking about past wins or losses.

• Inability to control or stop gambling

• Needing to gamble with increasing amounts of money to achieve the desired excitement.

• Restlessness or irritability when attempting to cut down or stop gambling.

• Chasing losses by returning to gambling to recoup previous losses.

• Lying to family members, friends, or therapists about the extent of gambling involvement.

• Jeopardizing relationships, employment, or educational opportunities due to gambling.

• Resorting to illegal activities or borrowing money to finance gambling.

• Experiencing feelings of guilt, remorse, or hopelessness after gambling.

• Neglecting personal responsibilities and neglecting self-care due to excessive gambling.

It is estimated that gambling disorder affects 2% to 7% of youth and 1% of adults and, as mentioned, may be rising. While the current numbers may not be high, friends and family of a person suffering from the disorder are often unintentionally harmed so the true percentage of people impacted by gambling addiction is significantly higher. 

How do I handle Abilify and compulsive gambling?

If you or someone you know exhibits signs of gambling while taking Abilify or any other medication, immediate consultation with a healthcare professional is essential. You may also feel the need to reach out or notify their doctor on their behalf.

Fortunately, if these signs emerge after recently starting Abilify or a similar drug, there is likely a cause for their sudden change in behavior, which is not always the case with a gambling disorder.

While reducing or stopping the medication may curb or completely eliminate the gambling disorder in the individual, it may be advisable to seek treatment or counseling specifically for the gambling disorder. A licensed therapist will be able to determine if the gambling disorder is directly tied to taking Abilify or is part of another undiagnosed issue.

Seeking Help

If you or someone you know is experiencing gambling-related problems while taking Abilify or any other medication, consulting a healthcare professional is essential. They can evaluate the situation, provide guidance, and determine the best course of action. It is important to note that stopping or reducing medication without proper guidance can result in unintended side effects and may require medical attention. 

Treatment for Gambling Addiction

While there may be many causes, recognizing and addressing gambling addiction is crucial for individuals who may be affected. Gambling addiction is a treatable condition, and various therapeutic approaches have proven to be effective. 

Again, if the gambling is connected to Abilify, decreasing use under the care of the prescriber will likely eliminate symptoms. Otherwise, people can pursue treatment options that include cognitive-behavioral therapy (CBT), which helps individuals identify and modify their gambling-related thoughts and behaviors, as well as support groups and self-help programs such as Gamblers Anonymous.

References:

• FDA Drug Safety Communication: FDA warns about new impulse-control problems associated with mental health drugs. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-new-impulse-control-problems-associated-mental-health

• Abilify official website. Retrieved from https://www.abilify.com/

• Compulsive gambling. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/compulsive-gambling/symptoms-causes/syc-20355178

• Fasano, A. et al. (2019). Gambling Disorder Associated with aripiprazole in a Patient with Bipolar Disorder: A Case Report. Journal of Gambling Studies. Retrieved from https://link.springer.com/article/10.1007/s10899-019-09828-1

• Gambling Disorder. Yale Medicine. Retrieved from https://www.yalemedicine.org/conditions/gambling-disorder

• Atik, A. et al. (2023). Sports Betting Boom Linked to Rising Gambling Addiction, Anxiety and Suicide. Newsweek. Retrieved from https://www.newsweek.com/2023/04/07/sports-betting-boom-linked-rising-gambling-addiction-anxiety-suicide-1789055.html