Partial agonist therapy in schizophrenia: relevance to diminished criminal responsibility.

Abstract

Pathological gambling (PG), classified in the DSM-IV among impulse control disorders, is defined as inappropriate, persistent gaming for money with serious personal, family, and social consequences. Offenses are frequently committed to obtain money for gambling. Pathological gambling, a planned and structured behavioral disorder, has often been described as a complication of dopamine agonist treatment in patients with Parkinson's disease. It has never been described in patients with schizophrenia receiving dopamine agonists. We present two patients with schizophrenia, previously treated with antipsychotic drugs without any suggestion of PG, who a short time after starting aripiprazole, a dopamine partial agonist, developed PG and criminal behavior, which totally resolved when aripiprazole was discontinued. Based on recent advances in research on PG and adverse drug reactions to dopamine agonists in Parkinson's disease, we postulate a link between aripiprazole and PG in both our patients with schizophrenia and raise the question of criminal responsibility.

• Authors: Gilles Gavaudan, David Magalon, Julien Cohen, Christophe Lançon, Georges Léonetti, Anne-Laure Pélissier-Alicot
• Journal: Journal of forensic sciences (J Forensic Sci) Vol. 55 Issue 6 Pg. 1659-62 (Nov 2010) ISSN: 1556-4029 [Electronic] United States
• PMID: 20579229 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2010 American Academy of Forensic Sciences.

Chemical References

• Antipsychotic Agents
• Piperazines
• Quinolones
• Aripiprazole

Topics

• Adult
• Antipsychotic Agents (administration & dosage, adverse effects)
• Aripiprazole
• Crime
• Forensic Psychiatry
• Gambling (chemically induced)
• Humans
• Male
• Middle Aged
• Piperazines (administration & dosage, adverse effects)
• Quinolones (administration & dosage, adverse effects)
• Schizophrenia (drug therapy)
• Violence