Problematic gambling associated with aripiprazole: 7 new case reports in a FEP cohort and a review of already published cases using a systematic approach.

Poster A113, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Olivier Corbeil1, Stéphanie Corbeil1, Ann-Sophie Breault1,2, Guillaume Chalifour1,2, Marc-Andre Roy2,3, Marie-France Demers1,2; 1Faculté de pharmacie, Université Laval, Québec, PQ, Canada, 2CNDV/IUSMQ/CIUSSS-CN, Québec, PQ, Canada, 3Psychiatrie et Neurosciences, Faculté de médecine, Université Laval, Québec, PQ, Canada

Aripiprazole, either its oral or long acting injectable formulation, is widely used among patients attending first episode psychosis programs (FEPP). Both Health Canada (2015) and the FDA (2016) emitted a safety warning about compulsive behaviors associated with aripiprazole including gambling, shopping, and hypersexuality. While psychosis itself is associated with an increased risk of developing problematic gambling, it remains unclear to what extent antipsychotics, particularly ones with partial agonist properties such as aripiprazole, may increase the likelihood of developing or may aggravate gambling problems. In this poster, we report a systematic approach using Naranjo Scale to review 7 new cases of problematic gambling associated with aripiprazole in a Quebec city FEPP. The same approach was applied also to cases published so far. The Naranjo, a reference pharmacovigilance scale, assessed the causal relationship of adverse drug reaction (ADR) and rates the intensity of this link. In addition to providing detailed descriptions of 7 new cases in young patients, we emphasise the importance to have access to longitudinal clinical patient’s follow-up and to various informants’ sources (health care providers, family members) to better estimate causal relationship between a drug and an ADR, particularly in problematic gambling in which covert behaviors are frequent. We were able to demonstrate a stronger link according to Naranjo Scores in our cases than in those published, in whom limited information was available to rate the Naranjo Scale. Our observations pave the road to a longitudinal nested case-control study using a systematic pharmacovigilance approach that is currently underway.

Topic Area: Psychopharmacology

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