Aripiprazole Provoking Gambling Disorder in a Patient With Opioid Use Disorder: A Case Report

Aripiprazole is an atypical antipsychotic used to treat certain mood disorders, such as bipolar disorder or schizophrenia, or as an adjunct therapy for treatment-resistant depression. In 2016, the FDA reported compulsive behaviors or uncontrollable urges can be associated with aripiprazole use. We report a 37-year-old Caucasian female with a past medical history of unspecified depressive disorder and opioid use disorder, who was treated with aripiprazole (Abilify) and then experienced compulsive gambling resulting in a suicide attempt. The patient reported playing scratch-off lottery tickets since childhood; however, she reported an ability to gamble responsibly and infrequently until one month before the admission. The patient started aripiprazole 10 mg daily, as an adjunct therapy for unspecified depressive disorder, approximately one year before the admission. We discuss the possibility of aripiprazole use, in combination with previous poor impulse control, intensifying recreational gambling to a level of gambling disorder. Because of the severity of these side effects, prior to beginning this medication, prescribing practitioners should consider if their patients have a history of compulsive behaviors and inform them of the potential for decreased impulse control with its use.