Problematic gambling associated with aripiprazole: design of a nested case-control study in a FEP cohort using a systematic pharmacovigilance approach.

Poster A112, 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 alert warning the population about compulsive behaviors associated with this agent including gambling, shopping, and hypersexuality. While psychosis itself is associated with an increased risk of developing problematic gambling, it remains unclear whether or not antipsychotics, particularly ones with partial agonist properties such as aripiprazole, also increase the likelihood of developing or aggravating gambling problems. In this poster, we will present the design of a retrospective nested case-control study using a pragmatic pharmacovigilance approach in a Quebec city FEPP (Clinique Notre-Dame des Victoires). All new cases of problematic gambling in the last 2 years will be identified and reviewed, notwithstanding which antipsychotic the patient was on and will then be compared to control patients matched for age, gender and duration of treatment. The Naranjo instrument, a reference pharmacovigilance scale that estimates the causal relationship of adverse drug reaction, will be applied to each case and will allow the determination of the antipsychotic’s imputability, as well as the evaluation of the strength of this association. This approach, combined to the longitudinal follow-up, will provide direly needed information concerning the association between aripiprazole and problematic gambling. In doing so, the results will shed light on new information to take into account when choosing the adequate antipsychotic regimen or providing appropriate monitoring for a given FEP patient.

Topic Area: Psychopharmacology

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