Healthcare professionals prescribing aripiprazole for schizophrenia and bipolar disorder should be alert to the known risk of patients developing addictive gambling, according to a new drug safety update.

This reminder about aripiprazole from the Medicines and Healthcare products Regulatory Agency (MHRA) comes after a rise in the number of reports of gambling or gambling disorder it received in 2023.

Between 1 January and 31 August 2023, the MHRA’s Yellow Card scheme received 32 reports of gambling or gambling disorder where aripiprazole was suspected to be the cause.

In the last 14 years, there have been 69 reports, making the 2023 figures over 46% of the total.

The MHRA asked gambling clinics in March 2023 to report any suspected cases, which may account for some of the rise, it said.

The reports of this suspected addictive behaviour 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.

The MHRA is advising patients 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.

And it warned that patients should continue taking aripiprazole as advised, as stopping the drug without medical advice can be harmful.

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.

She also highlighted that ‘aripiprazole is an effective and acceptably safe drug for many people’.

Professor Henrietta Bowden-Jones, director of the National Problem Gambling Clinic, added: ‘Clinicians prescribing aripiprazole must commit to consistently alert patients about these potential risks, both during the initial prescription and follow-up reviews.’

This includes asking patients if they have a personal history of excessive gambling or any other impulsive behaviours before prescribing aripiprazole.

This article was first published by our sister title Hospital Healthcare Europe