Aripiprazole-Induced Gambling Disorder as an Adverse Drug Reaction in Tourette Syndrome: A Case Report

Abstract

Aripiprazole is recommended as a first-line treatment for Tourette syndrome but has been associated with new-onset impulse control disorders, including pathological gambling, as highlighted by a 2016 Food and Drug Administration safety warning. Gambling disorder has rarely been reported in patients with Tourette syndrome receiving aripiprazole. We report a 43-year-old man with schizoaffective disorder and comorbid childhood-onset Tourette syndrome. Gambling behaviour began after an aripiprazole dose increase, persisted for about 12 months, and was diagnosed roughly 1.5 years after aripiprazole was started. Within weeks of tapering, gambling ceased and did not recurred over a 5-year follow-up. To our knowledge, this is the first reported case of gambling disorder as a possible adverse drug reaction to aripiprazole in a patient with comorbid Tourette syndrome. We hypothesise that partial D2/D3 agonism on an already sensitised dopaminergic system could have contributed; this remains speculative. Long-term monitoring of such patients should be considered.