Calling the Bluff: How America’s Top-Selling Antipsychotic Could Create Pathological Gamblers

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At 64 years old, Marie* had been battling schizophrenia for nearly half her life. After three decades of wrestling down a sense of stability, her new medication, aripiprazole, threatened to unravel it all. Six months after a modest bump in her dosage, a nasty and irresistible urge to gamble – a hunger previously unknown to Marie – began to gnaw away at her. She had dabbled with the poker machines, tossing in one or two Australian dollars at a time, but her small dalliances abruptly skyrocketed, costing her up to $700 AUD per session, sums which were anything but insignificant to her. “I just wanted to keep putting money in, it was an urgency,” she said. “I would go high…and I seemed to lose all reason.”

About 4.2% of adults in the United States suffer from serious mental illness. About 1-2% of Americans are pathological gamblers. In theory, these small numbers should never overlap. But one of the most-prescribed drugs in the world is quietly facilitating the collision of these two disorders in America, with devastating consequences.

Aripiprazole, sold under the brand name Abilify, has locked itself in place as one of the top selling drugs in the United States. An atypical antipsychotic, doctors prescribe Abilify to almost a million Americans each year. The drug treats one of the most sensitive populations in the U.S.—people suffering from schizophrenia, bipolar disorder, and major depression.

Abilify is widely regarded as an effective treatment for these serious mental disorders. But the drug comes at a dangerously high – and unknown – price. Study after study links aripiprazole to the onset of pathological gambling—even in people with no prior or familial history of the disorder. Tellingly, in many of the studies, the symptoms abate almost immediately after stopping the medication.

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