Abstract
Aripiprazole is an efficacious treatment for both the positive and negative symptoms of schizophrenia and is also commonly used as a mood stabilizer. It is associated with better tolerability compared with other antipsychotics. However, there are reports of patients who experience problem gambling, hypersexuality, obsessive–compulsive symptoms, and other impulsive and/or compulsive behaviors as a result of aripiprazole administration and/or dosage increase. We aimed to do a systematic review of case reports published in this regard. After screening more than 6000 titles and abstracts in ten scientific search engines, we found 35 related records comprising 59 cases. The majority of cases (n = 42, 71.18%) were male, the mean age was 33.83 years (± 13.40), and the average daily dose of aripiprazole was 11.63 mg (± 6.94). The results of our review showed that the most frequently published impulsivity adverse effect of aripiprazole is gambling, followed by hypersexuality, obsessive–compulsive symptoms/disorder, problem eating, trichotillomania, problem shopping, and kleptomania. These symptoms were experienced both by patients who had previous problems in these areas and those who did not. In the majority of cases, the symptoms appeared within 30 days after aripiprazole administration started and ceased within 30 days of its discontinuation and/or dose decrease. Clinicians should be aware of impulsivity adverse effects, monitor them, and educate both patients and the family about them.
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Appendix A
Appendix A
The Full Set of Search Terms related to impulse-control problems and compulsive behaviors
“compulsive, compulsion, compulsivity, compulsive behavior, pathological compulsive behavior, compulsive shopping, compulsive buying, excessive buying, oniomania, compulsive sex, compulsive sexuality, compulsive sexual behavior, compulsive hypersexuality, hypersexuality, sexual behavior, pornography, compulsive interest in sex, compulsive cybersex behavior, compulsive masturbation, compulsive social media use, compulsive alcohol use, compulsive substance use, compulsive gaming, compulsive video gaming, gaming disorder, gaming addiction, compulsive internet use, compulsive gambling, problem gambling, compulsive eating, binge eating, compulsive binge eating, eating disorder, bulimia nervosa, compulsive exercise, compulsive smoking, kleptomania, pyromania, trichotillomania, trich, hair pulling, excoriation, skin-picking, dermatillomania, hoarding, obsessive-compulsive disorder, obsessive-compulsive symptom, OCS, OCD, OCD symptoms, compulsive checking, compulsive washing, compulsive counting, body focused repetitive behavior, nail-biting, impulsive behavior, impulsive control disorder, ICD, compulsive, medication use, hobbyism, punding, suicidality, compulsive self-harm, onychophagia, impulse control disorder, impulsion, compulsive consumption, non-paraphilic compulsive sexual behavior, sexual compulsivity, nymphomania, satyriasis, Obsessive Compulsive Spectrum, compulsive lying, compulsive talking, tic, and Tourette”
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Akbari, M., Jamshidi, S., Sheikhi, S. et al. Aripiprazole and its adverse effects in the form of impulsive-compulsive behaviors: A systematic review of case reports. Psychopharmacology 241, 209–223 (2024). https://doi.org/10.1007/s00213-024-06529-5
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DOI: https://doi.org/10.1007/s00213-024-06529-5