Mrs Stephenson, a woman in her 50s, developed a severe gambling addiction after being prescribed the medication ropinirole for RLS, without being warned of the known risk of impulse control side effects.

She lives with her family and had no history of problematic gambling. She would occasionally place small bets on football or horse racing while watching events with her husband, typically spending no more than around £20 at a time.

Background to treatment

Mrs Stephenson was diagnosed with RLS during pregnancy, although her symptoms resolved after childbirth.

In 2019, her symptoms returned and she attended her GP. She was initially prescribed codeine, which provided relief. She was advised that ropinirole could be considered if her symptoms did not improve.

By January 2023, her symptoms had worsened and she returned to her GP surgery. She was prescribed Ropinirole and commenced treatment.

She was not warned about the potential side effects of the medication, including impulse control disorders such as pathological gambling.

Medication reviews and lack of monitoring

At a medication review in February 2023, Mrs Stephenson was recorded as being “settled on Ropinirole”. However, she was not advised of any behavioural side effects, and she was not specifically asked questions about any changes in mood or behaviour.

She subsequently attended two further reviews with different GPs at the practice. On each occasion, she was not warned of the risks or asked about any behavioural changes.

Development of gambling addiction

Shortly after starting Ropinirole, Mrs Stephenson began to notice a change in her behaviour.

She progressed from occasional, low-level gambling on the occasional weekend with her husband, to betting on sports she had no interest in, followed by online bingo and slot machines. Her gambling became increasingly frequent and difficult to control, continuing both day and night.

She knew that this was out of character for her, but she felt like she was not in control of her actions. She could not stop herself from gambling, no matter how much she tried, leading to a significant financial loss. Mrs Stephenson said “it seemed to make me lose track of my priorities. I didn’t care that I had been up all night and had work the next day” .

She was embarrassed about her actions and she felt ashamed about how much money was spending. Mrs Stephenson attempted to exclude herself from gambling sites through Gamstop but was later able to bypass restrictions and register with offshore operators. She repeatedly contacted gambling companies asking them to close her accounts, but her requests were not actioned. She also tried to contact her banks to block such payments to no avail.

As her financial situation worsened, she accessed pension funds in an attempt to rectify her financial position. She also experienced significant psychological distress and suicidal thoughts as a result of the impact such significant financial loss will have on her life. Due to the shame that she felt, and still feels, she has not told anyone about her behaviour. She was trying to maintain a full time job, manage her RLS symptoms, gamble and find ways to raise more money to gamble, all whilst pretending that she was ok.

Link to Ropinirole identified

In March 2025, Mrs Stephenson became aware of the association between dopamine agonist medications such as ropinirole and impulse control disorders, including pathological gambling.

“I immediately felt a small sense of relief, like I wasn’t alone.”

She immediately returned to her GP and stopped taking the medication under medical supervision. Within weeks, her urges to gamble significantly reduced.

Mrs Stephenson has now stopped taking ropinirole completely and she has not gambled since.

She has expressed concern that had she been warned earlier, she would have sought medical advice as soon as her behaviour changed, rather than suffering in silence because she didn’t know the cause.

“The fact that I had no idea it could be related to ropinirole meant it didn’t even cross my mind to speak to my GP about it. I was embarrassed and didn’t know why I was doing it. I didn’t dream it could be caused by my RLS medication” .  

Admissions by the Welsh Health Board

The Welsh Health Board, on behalf of the GP practice, has admitted that:

• There was a failure to warn Mrs Stephenson of the potential side effects of ropinirole at the time of prescription
• There was a failure to warn her of these risks during subsequent medication reviews
• There was a failure to ask about possible impulse control behaviours during follow-up appointments

It has also accepted that Ropinirole can cause impulse control disorders, including pathological gambling, and has apologised for the distress caused.

Legal outcome

Switalskis medical negligence team is now assisting Mrs Stephenson in quantifying her financial losses ahead of settlement discussions with the Defendant.

This case highlights the importance of clear warnings and proper monitoring when prescribing dopamine agonist medications such as ropinirole, particularly where known risks include compulsive behaviours.

For Mrs Stephenson, the outcome represents not only financial recovery, but recognition of what went wrong in her care and the impact it has had on her life.