|Patients who are prescribed a common antipsychotic used to treat depression, bipolar disorder, psychosis
and schizophrenia need to be told there is a risk they could develop a gambling addiction, an expert has warned.
Problem Gambling Clinic has observed growing numbers of patients who have developed a gambling addiction after starting to take aripiprazole. Some patients
have lost huge sums of money as a result and seen their relationships fall apart.
Prof Henrietta Bowden-Jones, a leading psychiatrist who runs the
clinic, said more awareness needed to be raised, as patients were not being warned by many GPs prescribing the drug, and mental health teams were failing to
monitor whether people were developing addictions.
This is not just any side-effect it can come with a risk of losing your own home. What
we constantly see is that not enough people know about this. I gave a recent lecture to all the psychiatrists in my trust and a very large proportion had never
heard about it, she said. We constantly hear about mental health teams not being aware. More needs to be done to prevent people from being put on
aripirazole without being warned and monitored.
The National Problem Gambling Clinics audit of its patients for 2022 found that nearly 9%
were taking the drug, or 30 out of 359. Bowden-Jones said they typically were not aware of the connection between aripiprazole and problem gambling.
GPs receive alerts of side-effects when they prescribe drugs, but although pathological gambling is listed as a side-effect by the National Institute
for Health and Care Excellence, it is not flagged. Mental health teams in psychiatric units often help monitor patients taking the drug, but are not
specifically looking out for warning signs of problem gambling.
There is government guidance for GPs to inform patients of the link between
medication and gambling addiction and how to monitor it.
Doctors should should be mindful that stigma and shame often prevents people reporting
symptoms of gambling harm, and look out for whether aripiprazole results in other compulsive behaviours, for example excessive drinking, drug-taking, sex or
shopping, added Bowden-Jones.
Lee Jordan developed a gambling addiction after taking aripiprazole in 2021 to ease psychosis symptoms, including hearing
voices, which developed during a highly stressful period of work. While he had gambled small amounts of money for fun in the past, his casual habit quickly
started to take over his life.
I was spending a huge amount of money because it was a release. But the devastating effects were humungous
I nearly lost my relationship, I lost family, friends, it just destroyed my life really, he said, adding that he had lost £10,000 to gambling
companies and been unable to recoup the money.
Jordan came off aripiprazole in 2022 and within weeks, he felt empowered to stop gambling. When I
came off the medication it was a struggle for a little bit, because it was ingrained in my brain those endorphins for the wins. There were cravings afterwards,
and I was able to install Gamban [gambling blocking software] on devices, but I needed a bit of willpower youve got to want to give up. With the
added pressure of aripirazole gone, it was easy for me to accomplish that goal.
Jordan is now on antidepressants, but will begin a new course of
antipsychotics soon, as he still hears voices intermittently, although he will not take aripiprazole again. Its a catch-22 do you want to
take it because you want to stop hearing voices, or do you want to keep damaging and ruining your life, and become homeless?
Paul Kanolik, a
lawyer at Ellis Jones specialising in gambling cases, said it was quite staggering how many people with psychiatric illnesses he was seeing ending
up with thousands of pounds of gambling debt. While he has won some cases, he said current legislation was a grey area, which needed to be
overhauled to better protect vulnerable people, especially given the accessibility of online gambling.
The Medicines and Healthcare products Regulatory
Agency said pathological gambling and other impulse control disorders were a well-recognised side-effect of aripiprazole, which are listed as
side-effects in the patient information leaflet. The MHRA recommends that patients and doctors always discuss the benefits and risks of any medication.