Anders Håkansson holds a position at Lund University which is supported by the stateowned Swedish gambling operator AB Svenska Spel as part of its responsible gambling policies, and also has research funding from the research councils of that body and from the research council of the Swedish alcohol monopoly, Systembolaget. Data are available from the Swedish National Board of Health and Welfare, SE-106 30 Stockholm, Sweden (contact via +46 (0)75 247 30 00 or for researchers who meet the criteria for access to confidential data.įunding: The authors received no specific funding for this work.Ĭompeting interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Mirjam Wolfschlag declares no competing interests. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data cannot be shared publicly because they contain confidential patient information, and the authors hold no permission to share them. Received: ApAccepted: Published: June 1, 2021Ĭopyright: © 2021 Wolfschlag, Håkansson. PLoS ONE 16(6):Įditor: Kenji Hashimoto, Chiba Daigaku, JAPAN Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders.Ĭitation: Wolfschlag M, Håkansson A (2021) Increased risk for developing gambling disorder under the treatment with pramipexole, ropinirole, and aripiprazole: A nationwide register study in Sweden. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved.
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