title: Risk of Gambling Disorder and Impulse Control Disorder With Aripiprazole, Pramipexole, and Ropinirole: A Pharmacoepidemiologic Study.
abstract: BACKGROUND
  Recently, the US Food and Drug Administration issued a warning regarding the potential risk of gambling disorder, but large epidemiologic studies are lacking.
  
  
  METHODS
  We used a large health claims database from the United States and conducted a nested case-control study. Cases were defined as subjects newly diagnosed with gambling disorder or impulse control disorder. For each case, 10 controls were selected and matched to cases by age and follow-up time and calendar time. Adjusted rate ratios were computed with conditional logistic regression.
  
  
  RESULTS
  There are 355 cases of gambling disorder and 3550 controls along with 4341 cases of impulse control disorder and 43,410 corresponding controls. After adjusting for confounders, users of aripiprazole demonstrated an increased risk of pathologic gambling (rate ratio [RR], 5.23; 95% confidence interval [CI], 1.78-15.38) and impulse control disorder (RR, 7.71; 95% CI, 5.81-10.34). The risk was also elevated for pramipexole or ropinirole for both gambling disorder and impulse control disorder (RR, 7.61; 95% CI, 2.75-21.07; RR, 3.28; 95% CI, 2.31-4.66, respectively).
  
  
  CONCLUSIONS
  Our study confirms an association between aripiprazole, pramipexole, or ropinirole and impulse control disorder and gambling disorder.
authors.affiliation: From the Departments of *Ophthalmology and Visual Sciences, and †Psychology, University of British Columbia, Vancouver, British Columbia, Canada; ‡Department of Neurology, University of Washington, Seattle, WA; §Department of Psychiatry, ∥Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, and ¶Child & Family Research Institute, University of British Columbia; and #Pharmaceutical Outcomes Programme, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Mahyar
authors.initials: M
authors.lastname: Etminan
authors.forename: Mohit
authors.initials: M
authors.lastname: Sodhi
authors.forename: Ali
authors.initials: A
authors.lastname: Samii
authors.forename: Ric M
authors.initials: RM
authors.lastname: Procyshyn
authors.forename: Michael
authors.initials: M
authors.lastname: Guo
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Carleton
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole / Q000009:adverse effects*; D052160:Benzothiazoles / Q000009:adverse effects*; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000139:chemically induced* / Q000453:epidemiology; D018491:Dopamine Agonists / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D005715:Gambling / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D000077487:Pramipexole
chemical_list: D014150:Antipsychotic Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D007211:Indoles; C046649:ropinirole; D000068180:Aripiprazole; D000077487:Pramipexole