Canada: Abilify Impulse Control: The Costly Side-Effects Of One Of Canada's Most Prescribed Drugs

Last Updated: February 9 2017
Article by Paul Miller

Think back to the last time you had a prescription filled. Perhaps you're fortunate enough to have a drug plan. If not, you might have winced a bit as the total popped up on the cash register's display. What was the damage to your pocket book? Whatever the number, it's probably a lot lower than the $250,000 one Canadian man ended up paying for his Abilify prescription.

That $250,000 wasn't the cost of the prescription itself, of course; rather, it was how much he ended up gambling away as a result of the drug's impact on his ability to exercise impulse control. In this blog post, I explore the troubling potential side effects of one of Canada's most commonly prescribed drugs. The cost of these side effects – to your finances, your health, and your relationships – are ones no one should ever have to pay – especially without full knowledge of the risks.

What is Abilify?

Aripiprazole, often branded as Abilify, Abilify Maintena, or Aristada, is a second-generation, atypical anti-psychotic drug. Heralded as a breakthrough, this drug is known as a stabilizer because unlike first-generation anti-psychotics, it adjusts dopamine and serotonin levels in the brain rather than simply blocking chemical receptors.

In Canada, it was approved to treat schizophrenia and bipolar (Type I) in people 13 years of age or older. It is also frequently prescribed "off-label" to treat conditions such as Tourette's syndrome, irritability related to autism, anxiety disorders, ADHD, and general depression.

Like most legally approved pharmaceuticals, Abilify is considered generally safe but known to cause side effects in some people. These include, but are not limited to:

  • Nausea and/or vomiting;
  • Dizziness;
  • Blurred vision;
  • Headache;
  • Insomnia;
  • Restlessness (akathisia) or uncontrolled body movements (tardive dyskinesia);
  • Neuroleptic malignant syndrome (NMS);
  • High blood sugar (hyperglycemia) and diabetes;
  • Orthostatic hypotension (decreased blood pressure);
  • Low white blood cell count;
  • Seizures (convulsions); and
  • Strokes in the elderly

Impulse Control Issues

Although Abilify's makers have been forthcoming about the risk of these side effects, they were slow to divulge other serious potential side effects concerning impulse control. Medical case studies and patient reports revealed incidents of problem gambling, binge eating or compulsive eating, compulsive shopping and hypersexuality while users were taking Abilify. When some of these patients stopped taking the drug this behaviour ceased, strongly suggesting a link.

Moreover, research discovered that certain Abilify users – people with personal or familial histories of obsessive-compulsive disorder (OCD), alcohol and drug abuse, bipolar disorder, and other types of impulsive personalities or addictive behaviours – were particularly at risk of experiencing these side effects. Yet some people who had not previously experienced difficulties with impulse control were also affected.

Where Were The Warnings?

One of the most frustrating aspects of this story is evidence that Abilify's maker knowingly made "false or misleading" statements about the drug that slowed federal regulators from taking action to protect users sooner. Stricter labelling standards and information protocols in Europe meant doctors and patients were warned of these serious side effects in 2012 – three years before the US Food and Drug Administration and Health Canada took action. Probably as a result, Abilify is prescribed much less frequently in Europe than in North America.

Why the delay? Arguably, Abilify's makers knew that by advertising these risks there would be a cost to their bottom line that they sought to postpone paying as long as possible. Unfortunately, in the interim, some people taking Abilify were paying a huge cost of their own. In addition to the monetary losses from uncontrollable gambling, shopping or food and drug abuse, these victims engaged in behaviour which undoubtedly increased their risk of physical harm, ill health and strained relationships.

Seeking Justice

It is unconscionable that drug makers would knowingly expose these people to such risks without adequate warning. Preventing people from making an informed decision about their health care demands serious consequences. In addition to seeking compensation for physical, mental and economic damages, some victims are looking to ensure the drug's manufacturers faced punitive damages for their role.

In Canada, Abilify victims have come together to participate in a mass tort action. Unlike class action lawsuits, mass tort actions allow people who have suffered various degrees of injury (and therefore cannot be grouped into a single class of plaintiffs) to proceed with cases individually or collectively. This type of action, funded on a contingency basis, reduces the financial barriers to participation and provides flexibility to victims. They may seek to use awards structure established by others' cases as the basis for settlements or to pursue their own distinct claim.

In consultation with a medical professional, when deciding whether to take a drug known to cause potential side effects, a patient must weigh the benefits of the drug versus its risks. By withholding key information, Abilify's makers skewed the odds and made this decision more of a gamble than some people would be willing to take otherwise. They should be held accountable for their actions and the damage it has caused.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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