Psychopharmacology: aripiprazole and impulse control: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: aripiprazole and impulse control

Sample item

A 40-year-old man with schizophrenia stable on aripiprazole begins to gamble compulsively, running up large debts and hiding it from his wife. He had no such behaviour earlier. What is the most likely cause?

ADrug-induced impulse-control disorder from dopamine partial agonismBTardive dyskinesiaCHyperprolactinaemiaDRelapse of negative symptoms

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Drug-induced impulse-control disorder from dopamine partial agonism

Aripiprazole and dopamine agonists can cause pathological gambling, shopping, hypersexuality and binge eating. Clinicians should ask about these behaviours, and dose reduction or a change of drug usually reverses them.

Option by option

A. Drug-induced impulse-control disorder from dopamine partial agonism (correct)
Correct. Impulse-control disorders are a recognised effect of dopamine partial agonists.
B. Tardive dyskinesia
Tardive dyskinesia is an involuntary movement disorder.
C. Hyperprolactinaemia
Hyperprolactinaemia causes galactorrhoea and sexual dysfunction, not gambling.
D. Relapse of negative symptoms
Negative symptoms reduce drive and would not produce compulsive gambling.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Drug-induced impulse-control disorder from dopamine partial agonism. Aripiprazole and dopamine agonists can cause pathological gambling, shopping, hypersexuality and binge eating.

Why is "Tardive dyskinesia" not the answer?

Tardive dyskinesia is an involuntary movement disorder.

Why is "Hyperprolactinaemia" not the answer?

Hyperprolactinaemia causes galactorrhoea and sexual dysfunction, not gambling.

Why is "Relapse of negative symptoms" not the answer?

Negative symptoms reduce drive and would not produce compulsive gambling.

What concept does this question test?

It tests Psychopharmacology: aripiprazole and impulse control in Psychiatry. Clinicians should ask about these behaviours, and dose reduction or a change of drug usually reverses them.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: aripiprazole and impulse control?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.