the complex scientific and judicial history of aripiprazole.

It all started shortly after starting treatment with those pills. It is not easy to explain: a compulsion, an irrepressible urge, a failure to stop. Sometimes it was the game, other times the food. Or drugs, sex, or any compulsive behavior. It was like losing control of your own life; it was like getting it back right after stopping aripiprazole.

This is the story that has led hundreds of people to sue the manufacturers of one of the most prescribed drugs in the world for causing compulsive behaviors. A connection that is not clear in the light of science and that will have to be resolved in court. Really a medicine can make us spend all our savings on a blackjack table?

the complex scientific and judicial history of aripiprazole

History of a drug

Aripiprazole was approved in 2002 as an anti-schizophrenia drug. Over the years, its use was expanded to also reach bipolar disorder, irritability in ASD, Tourette’s syndrome or major depression. This has allowed that, despite not being in all the medicine cabinets in the world, has become one of the most popular medications. Above all, since it began to be marketed as a generic.

For the rest, the history of the drug has been complex, full of lights (not only is it one of the safest drugs out there, but it was the first smart pill approved in the US) and shadows (with repeated legal problems for unauthorized uses in children and the elderly). But none of that slowed his popularity. You don’t even suspect that something strange was happening to some patients. Few, at first; but increasingly, as the drug became popular. That’s where the problems started.

the complex scientific and judicial history of aripiprazole

The mystery of compulsive behavior

Between the approval of the drug and the time the FDA advised of the side effects 14 years and 184 cases passed. Very few for a drug that was consumed “in industrial quantities”, but more than enough for other countries to have taken action earlier: Europe, without going any further, had taken action on the matter four years earlier, in 2012.

For years the FDA has defended itself by explaining that, despite investigations, the mechanism is not known why the drug produces these compulsive behaviors. Which is a fancy way of saying that, with so few cases, correlation doesn’t imply causality, or anything like that.

the complex scientific and judicial history of aripiprazole

It’s true. And yet the fact is that most of the cases studied had no history of impulse control problems: everything insistently points to aripiprazole, compulsive behaviors begin and end with it. Namely, firm evidence is lacking, but suspicions abound.

Given this, with the problem on the table, the resolution will fall into the hands of the judges and we already know that scientific truth does not always coincide with judicial truth. If at some point we manage to find out what the judicial truth is, of course.

the complex scientific and judicial history of aripiprazole

This is not being easy: the first three lawsuits have been resolved with out-of-court settlements just before the failure and everything seems to indicate that it will happen again with the following ones. There is a long time to know what really happens with aripiprazole.