FDA Warns of Compulsive Behaviors Associated with Antipsychotic Aripiprazole

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The antipsychotic drug aripiprazole (marketed as Abilify, Abilify Maintena, and Aristada) is associated with compulsive or uncontrollable urges to gamble, have sex, shop, or binge eat, the FDA warned on Tuesday.

Aripirazole, a partial dopamine agonist, already carries a warning about compulsive gambling, but "this description does not entirely reflect the nature of the impulse-control risk," the FDA says. The agency has identified 184 case reports of impulse-control behaviors in adults and children since the drug was first approved in 2002.

The agency instructs clinicians to alert patients and caregivers about this risk when prescribing the drug. Providers should monitor new and increasing urges in patients at higher risk, such as those with a personal or family history of impulse-control disorder, bipolar disorder, impulsive personality, obsessive-compulsive disorder, substance use disorder, or other addictive behaviors. If urges occur, clinicians should consider stepping back the dose or discontinuing the drug.