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Treating Patients with Aripiprazol: A Safe Gamble?

Published online by Cambridge University Press:  01 September 2022

B. Leal*
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
D. Vila-Chã
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
S. Garcia
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
I. Pinto
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
R. Mateiro
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
M. Avelino
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
M. Martins
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
J. Salgado
Affiliation:
Centro Hospitalar Psiquiátrico de Lisboa, Clínica 1, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

Aripiprazole (ARI) is an atypical antipsychotic drug with D2 partial agonist properties, usually prescribed to treat mood disorders (major depression or bipolar disorder) and schizophrenic disorder (schizophrenia or schizoaffective disorder). Dopamine receptor agonists, as is ARI, have been implicated in some cases of impulse-control problems, such as gambling disorder (GD), increased spending, hypersexuality and compulsive eating.

Objectives

Currently, it is hypothesized 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 intend to do a non-systematic review of the scientific information regarding this subject.

Methods

The authors revised the published literature about this topic, selecting relevant articles, systematic reviews and case reports, with the topic words: “aripiprazol”, “gambling disorder” and “dopamine receptor” in scientific data base.

Results

Overall, a few cases of ARI-induced pathological gambling as well as ARI-induced hypersexuality have been reported. In one study it was verified that comorbid psychiatric and substance use disorders were common among those who have experienced GD or worsened GD after beginning ARI treatment. In another study, it was verified that the group of patients who reported this alleged side-effect were mostly young (mean age, 33.6 years), mostly men (88.2%) and most lived alone.

Conclusions

Attributing to dopamine agonists the only factor that can explain the onset of GD is simplistic and dangerous. Many other potential risk factors, including individual vulnerability factors (temperament, genetics) as well as environmental factors, must be considered.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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