Our expert medical negligence solicitors are supporting a number of people who are experiencing serious and often life-changing harm from mismanaged dopamine agonist medication – and now our experts have expressed concern after seeing new and serious cases involving one drug prescribed by psychiatrists – aripiprazole .

Having already received dozens of enquiries relating to other medications such as ropinirole, pramipexole and rotigotine – which are used to treat conditions such as Restless Legs Syndrome (RLS), Parkinson’s disease – our expert team at Switalskis are now receiving more enquiries from patents whose lives have been turned upside down by aripiprazole. Aripiprazole is an antipsychotic medication which it usually prescribed by psychiatrists. As a dopamine agonist, it carries similar side effects.  

Our experts have warned that the latest cases show that patients are still being prescribed aripiprazole and other dopamine agonist medication without being warned of the risks, despite the high number of cases involving patients demonstrating changed and compulsive behaviour.

This includes compulsive gambling by patients who had no prior history of gambling to any significant level but who have run up gambling losses into the tens and sometimes hundreds of thousands of pounds after being prescribed aripiprazole, as well as other dopamine agonist medications.

Aripiprazole is primarily prescribed by psychiatrists for patients with significant mental health conditions but our specialist clinical negligence team is now hearing worrying stories about compulsive behaviour developing suddenly among those to whom it has been prescribed.

Our experts are now calling for greater awareness among all prescribers about the potential side effects of aripiprazole, pramipexole, ropinirole and rotigotine, to prevent other patients suffering similar harm and changed behaviour, which in many cases has led to debt issues and relationships with family and friends being seriously affected.

‘Unimaginable stories’: our expert’s view

Kimberley Davies , an Associate Solicitor and medical negligence specialist at Switalskis, is already supporting more than a dozen patients who have suffered life-changing side effects from dopamine agonist medication and expressed concern over what she has seen and heard from those affected.

“The stories we are hearing from those affected are unimaginable and heart-breaking. There are people staying up all night to gamble, who would never have gambled before, and running up huge losses, when previously gambling wasn’t a big part of their lives, it at all,’” she said.

“One client has told us how she changed her route to work so that she would not lose signal and could continue to gamble on her commute. She couldn’t bear the thought of being unable to gamble for a short period of time, something which she had not done before.” This client said “the compulsion to gamble was all-consuming and it quickly took over my life. I tried everything I could to stop but I just couldn’t. I was embarrassed and ashamed and so I tried to hide it from everyone. I just didn’t know why I was doing it. It was so out of character”. 

Kimberley said “This is an issue around which there has been awareness for some time. Warnings about impulse control disorders relating to aripiprazole were published in the British National Formulary (BNF), a widely used medical resource, in December 2023 but we are regularly hearing from patients who have been prescribed aripiprazole after this warning and were still not made aware of such risks. This isn’t old news. It’s still happening and people are still being affected by this”.

“More has to be done to make prescribers aware of the potential consequences of prescribing these drugs and to ensure patients are aware of the potential side effects. People can’t be left to deal with this on their own, as the evidence shows that the consequences can be life-changing.”

What is aripiprazole?

Aripiprazole (brand name: Abilify) is an antipsychotic medication used to treat mental health conditions such as schizophrenia and bipolar disorder.

Aripiprazole is a dopamine agonist medication, which means it affects the chemicals in the brain to increase dopamine and serotonin. It does not cure the condition, but it can help with the symptoms.

What are the side effects of aripiprazole?

In addition to common side effects such as headaches, difficulty sleeping, feeling anxious, restlessness and constipation, it is now known that dopamine agonists such as aripiprazole can affect impulse control. This is the inability to resist the impulse or temptation to perform an act that could be harmful to the patient or others, including gambling, binge eating, excessive spending and hypersexuality.

It is important that patients are made aware of these risks when the medication is prescribed, and reminded of such risks at every medication review.

How long has the link between aripiprazole and impulse control disorders been known?

This link has been known in the US for many years and there have been many successful claims against the manufacturers in the US. It also seems to have been recognised by medicines regulars in the European Union, since about 2015. However, it seems that the UK did not take action until much later.

The patient information leaflet from December 2021 lists the following as a side-effect:

“Inability to resist the impulse, drive or temptation to perform an action that could be harmful to you or others which may include:

• Strong impulse to gamble excessively despite serious personal or family consequences
• Altered or increased sexual interest and behaviour of significant concern to you or others, for example, an increased sexual drive
• Uncontrollable excessive shopping
• Binge eating (eating large amounts of food in a short time period) or compulsive eating (eating more food than normal and more than is needed to satisfy your hunger
• A tendency to wander away”

In December 2023, a warning was added to the BNF, the UK’s authoritative guide to medicines, to advise all healthcare professionals that there had been an increase in reports of gambling in patients taking aripiprazole and therefore they should make patients and their carers (if applicable) aware of the risk of new or increased urges to gamble and other impulse control symptoms, such as excessive eating, spending or hypersexuality.

Even though this does now seem to be well known, we are still commonly seeing doctors failing to warn their patients of this.

What if I was not told of the side effects?

We are acting for a number of patients who have been prescribed dopamine agonist medication (such as aripiprazole) who have not been made aware of the side effects. This means that when the impulse control behaviour starts, many patients do not realise that this is associated with the medication. They tend to be embarrassed of the behaviour and therefore try to hide it, rather than seek help. The behaviour continues and the financial losses, or other damage, often spiral out of control.

We may be able to prove that it was a breach of duty to prescribe aripiprazole at all (based on individual circumstances) or that it was a breach of duty not to warn of the side effects when it was first prescribed, and at every review appointment. We may then be able to show that if the patient had been aware of such side effects, they would have contacted their GP much sooner and the medication would have been stopped, often resulting in less harm.