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Pathological gambling induced by dopamine antagonists: a case report.
Philipp Grötsch1, Claudia Lange, Gerhard A Wiesbeck
1Psychiatric Hospital of the University of Basel, Wilhelm Klein-Strasse 27, 4012, Basel, Switzerland.
Journal of Gambling Studies
|December 21, 2013
Summary
Antipsychotic medication, specifically flupentixole, may trigger pathological gambling in susceptible individuals. Discontinuing these antidopaminergic agents and switching to bupropion resolved the excessive gambling behavior.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Pathological gambling is an impulse control disorder characterized by persistent, maladaptive gambling behavior.
- While often considered non-pharmacological, associations between pathological gambling and dopamine agonist use have been noted.
Observation:
- A 28-year-old male patient with major depressive episode and post-traumatic stress disorder was treated with duloxetine and maprotiline.
- Administration of the antipsychotic flupentixole (up to 7 mg) transformed a casual online poker player into an excessive gambler.
Findings:
- The excessive gambling behavior ceased only after discontinuing the antidopaminergic agents (flupentixole).
- Switching the patient's medication to bupropion also coincided with the cessation of gambling.
Implications:
- This case suggests a potential causal relationship between dopamine antagonists and the development of pathological gambling.
- Further research into the dopaminergic pathways involved in impulse control disorders and medication side effects is warranted.
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