title: Pathological Gambling Associated With Aripiprazole or Dopamine Replacement Therapy: Do Patients Share the Same Features? A Review.
abstract: BACKGROUND
  In the last 10 years, dopamine replacement therapy (DRT) has become a well-known risk factor for developing an impulse control disorder, such as gambling disorder (GD). Another medication, aripiprazole (ARI), has been more recently identified as another risk factor. Dopamine replacement therapy and ARI share a dopamine agonist action. Our work aimed at comparing patients with PG according to their treatment with DRT or ARI.
  
  
  METHODS
  Two methods were combined-a systematic review concentrated on case reports and the analysis of a French disordered gamblers cohort focused on patients using ARI or DRT at inclusion.
  
  
  RESULTS
  We reported 48 cases of GD possibly due to DRT and 17 cases of GD possibly due to ARI. Because of their standardized assessment, only the EVALJEU patients could be compared. Two clinical patterns emerged. Patients in the ARI group were young, impulsive, and high novelty seekers and had a history of substance misuse. Their first gambling experience occurred during adolescence. Conversely, patients in the DRT group were old, and they began gambling late in life. They showed low levels of gambling-related cognition.
  
  
  CONCLUSIONS
  Patients in the ARI group seemed to be more severe pathological gamblers than patients in the DRT group. Aripiprazole is a partial D2 receptor agonist, whereas DRT includes full D2 receptor agonist. The trigger mechanism of PG development is complex and cannot only be attributed only to the pharmacodynamic effects of dopaminergic drugs. Indeed, individual vulnerability factors and environmental factors need to be considered.
authors.affiliation: From the *Clinical Investigation Unit, "Behavioral Addictions/Complex Affective Disorders," Department of Addictology and Psychiatry, CHU Nantes; †EA 4275 "Biostatistics, Pharmacoepidemiology, and Subjective Measures in Health Sciences," Université Nantes; Departments of ‡Pharmacology, and §Neurology, CHU Nantes, Nantes, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Grall-Bronnec
authors.forename: Anne
authors.initials: A
authors.lastname: Sauvaget
authors.forename: Fanny
authors.initials: F
authors.lastname: Perrouin
authors.forename: Juliette
authors.initials: J
authors.lastname: Leboucher
authors.forename: François
authors.initials: F
authors.lastname: Etcheverrigaray
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Challet-Bouju
authors.forename: Louise
authors.initials: L
authors.lastname: Gaboriau
authors.forename: Pascal
authors.initials: P
authors.lastname: Derkinderen
authors.forename: Pascale
authors.initials: P
authors.lastname: Jolliet
authors.forename: Caroline
authors.initials: C
authors.lastname: Victorri-Vigneau
mesh_terms: D000293:Adolescent; D000068180:Aripiprazole / Q000009:adverse effects* / Q000494:pharmacology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000494:pharmacology; D005715:Gambling / Q000139:chemically induced*; D006801:Humans; D017448:Receptors, Dopamine D2 / Q000819:agonists; D012307:Risk Factors
chemical_list: D018491:Dopamine Agonists; D017448:Receptors, Dopamine D2; D000068180:Aripiprazole