"It's been a long time since I drank like that": A case report of binge drinking associated with aripiprazole

Aripiprazole has been linked to the development of impulse control problems (ICPs), most commonly gambling. Aripiprazole's effect on serotonergic and dopaminergic pathways has had mixed results on drinking behaviors. A male patient receiving outpatient psychiatric care presented with ongoing symptoms of depression on his current regimen of mirtazapine and gabapentin. Aripiprazole was chosen for augmentation after multiple failed trials of alternative medications. Within 3 weeks the patient discontinued the medication due to escalating binge-drinking behavior. This behavior resolved within 3 days after discontinuing aripiprazole. Individuals who engage in binge drinking demonstrate consistent impulse control deficits that are unrelated to the rewarding effects of alcohol. Aripiprazole may be related to this patient's return to binge drinking from an ICP standpoint rather than driven by alcohol cravings as other psychosocial factors remained stable throughout this time.