Compulsive Gambling and Abilify
By David Carnes, Staff Writer
Ablify, also known as Aripriprazole, is an atypical antipsychotic developed by Otsula Pharmaceutical Co.. Ablify has grown into one of the most popular prescription drugs in the world since its introduction in 2002– at least 8.7 million prescriptions are written per year, bringing in billions of dollars every year for Otsuka and Bristol-Meyers, Otsuka’s marketing partner. The generic version of the drug was approved in 2015, opening up the market for other players.
Originally, Ablify was used to treat only schizophrenia; however, because of the relative rarity of this condition, the money didn’t really start rolling in until the U.S. Food and Drug Administration (the FDA) approved it for other uses such as bipolar disorder, depression, autism and other maladies.
Unfortunately, Ablify is associated with a host of negative side effects, including:
- Compulsive behaviors
- Suicidal thoughts
- Uncontrollable movements
Perhaps the most devastating side effect of Ablify is its triggering of compulsive behaviors such as gambling, eating, shopping and sex. The evidence of this connection is not just anecdotal -- a study conducted by the British National Problem Gambling Clinic concluded that there is a link between gambling and the use of Ablify, and other studies have corroborated this finding. Gambling addiction has been a particularly devastating side effect of the use of Ablify, because it results in entire families drowning in gambling debts. Some users have even resorted to crime to fund their gambling addiction.
Ablify stimulates the production of dopamine in the brain, which is responsible for the reward or feeling of gratification that accompanies compulsive behavior. Although the exact mechanism is unknown, it is thought that the over-stimulation of dopamine 3(D3) receptors makes it difficult or impossible for the user to refrain from compulsive harmful behaviors that are encouraged by a malfunctioning dopamine reward system.
Hundreds of cases of compulsive behaviors traced to the use of Ablify and similar drugs have been documented. The cause and effect relationship is relatively well-established -- there is solid evidence that these compulsive behaviors develop only after the user began taking Abilify, and that users typically stop their compulsive behavior after being taken off Ablify. In May 2016, the FDA issued a public safety warning concerning the ability of Ablify and other aripiprazole drugs to trigger compulsive behaviors. The warning notice it also announced that it was adding new warnings to the relevant drug labels and Medication Guides.
Dozens of lawsuits against Otsuka America and Bristol Meyers have been filed in 2016 alone, some in state court and some in federal court. These lawsuits allege that the drug was marketed without proper warnings, causing people to take Ablify without awareness of its risks. In October 2016, all federal lawsuits were centralized into Multi-District Litigation in the U.S District Court for the Northern District of Florida. Class action litigation is being contemplated by several major law firms.
Is It Enough?
Warnings may not be enough to offset the damage done by Ablify’s triggering of compulsive behaviors. Considering the risks, it might be appropriate for the FDA to restrict the use of Ablify to treating schizophrenia. If the use of Ablify cannot be restricted to schizophrenics, a conspicuous “black box” warning should be included with packaging. From a civil litigation perspective, verdicts and settlements should reflect the true losses suffered by the victims – gambling debts, for example. Punitive damages should be considered if it turns out that Otsuka was aware of Ablify’s risks yet ignored them for marketing purposes.