Bristol-Myers Squibb and the Otsuka Pharmaceutical Company market Abilify as an add-on treatment to other anti-depressants and as a treatment for other mental illnesses. But the blockbuster drug is also linked to serious side effects like suicidal thoughts, sexual dysfunction and compulsive gambling.
What is Abilify?
If you are one of millions of Americans who live with major depression, bipolar disorder or schizophrenia, atypical antipsychotic drugs like Abilify can make a difference in your quality of life. Mental illnesses can cripple, and doctors prescribe these drugs to manage symptoms and help people live more normal lives.
The Otsuka Phamaceutical Co. developed Abilify (aripiprazole), and the U.S. Food and Drug Administration (FDA) first approved it in 2002 as a treatment for schizophrenia. Otsuka partnered with Bristol-Myers Squibb to market it.
However, the number of people diagnosed with schizophrenia is small, so to make the antipsychotic drug more profitable, Otsuka and Bristol-Myers asked the FDA to approve Abilify for more uses. It is most often marketed today as a combination medication with other prescription drugs to treat major depression, although it also has many other approved uses.
Despite its widespread popularity, Abilify carries a set of potentially devastating side effects, including thoughts of suicide, involuntary muscle movements and compulsive behaviors. The addictive behaviors that often surface are overeating and pathological gambling. The drug carries and FDA black box warning related to suicidal thoughts in young adults and death in older users.
These after-effects led to lawsuits against Bristol-Myers Squibb and Otsuka America Pharmaceuticals for failing to warn them of the side effects and selling a defective drug.
How Does Abilify Work?
Newer antipsychotic drugs like Abilify – called second generation antipsychotics (SGAs) – work differently than older ones like Thorazine and Haldol, referred to as first generation antipsychotics (FGAs). FGAs target only dopamine receptors and have a greater risk of neurologic side effects. SGAs work on both dopamine and serotonin.
Other antipsychotics in the same class as Abilify include drugs such as Risperdal, Invega and Zyprexa. These drugs have fewer movement side effects, like tardive dyskinesia, than older drugs.
Abilify also works differently than many other SGAs. Other drugs in the class block chemical receptors in the brain for dopamine or serotonin to control symptoms. Aripiprazole works by either enhancing dopamine and serotonin levels or inhibiting them to keep a balance. Many doctors call the drug a stabilizer, which explains why it is prescribed alongside other medications – to enhance their effectiveness.
This stabilizer effect is one reason doctors prescribe the drug so often, even for off label uses like anxiety, obsessive-compulsive behavior, irritability and aggression. Because Abilify sits in a category of its own, medical researchers are conducting clinical trials to see if it can become a treatment for a broader range of maladies.
However, just because the drug seems useful for a variety of symptoms, it doesn’t mean that it is entirely safe and without side effects.
Abilify and Compulsive Gambling
One of the more disturbing side effects of Abilify is its link to compulsive behaviors such as binge eating and compulsive gambling, also called pathological gambling. Some doctors say the drug promotes these behaviors because of the way it works with dopamine.
When a person has a pathological symptom, a brain irregularity makes some behaviors virtually impossible to stop without assistance. Pathological gamblers have a difficult time walking away from slot machines, blackjack tables, casinos, poker tournaments and from betting on sports even if they don’t have money to lose. One result is that they gamble on credit and drive themselves into serious debt.
Abilify and Medical Studies
In post-market data compiled about Abilify, some patients reported pathological gambling. A number of studies also link the medication to compulsive betting. One 2010 case study published in the Australian & New Zealand Journal of Psychology relates the story of one woman with schizophrenia who took Abilify, gained nearly 20 pounds in six months through compulsive eating and gambled away thousands of dollars. She had no prior history of such behavior.
After her doctors took her off the medicine, the urge to gamble stopped in a month and she even lost weight.
Other studies from 2011 and 2013 also point to pathological gambling as a side effect of aripiprazole. Once the medication was stopped, the symptoms also stopped.
“We recommend consideration with increased attention for the appearance of pathological gambling symptoms among patients on aripiprazole,” authors of the 2011 study wrote.
Other Side Effects
Along with compulsive behavior, Abilify’s other side effects range from bothersome to dangerous. Clinical studies detail them as: