Efficacia di Aripiprazolo Long-Acting nel disturbo schizoaffettivo associato a gioco d’azzardo patologico. Un case report.

The pathological gambling results from the interaction of multiple risk factors. Among these, the second-generation antipsychotic (SGA) aripiprazole has been described as a new potential risk factor. In this work we present the case of a young man, affected by schizoaffective disorder and pathological gambling, who showed significant improvements of both conditions after aripiprazole long acting administration. We discuss the importance of a complete assessment, that could evidence all psychopathological factors implicated in the onset or worsening of a pathological gambling, included, in this case, the schizoaffective disorder. The aripiprazole long acting was well tolerated and, compared with the oral aripiprazole, produced less sedative effects, favoring, at the same time, a good compliance to the therapy. Between the side effects we remark the weight gain -often find in all the SGA-, that was managed with a psycho-educational and nutritional approach. An important reflection regards the health service chosen by the patient, i.e. the Dependence Service, considered as less stigmatizing and suitable for his debt condition. We think that the Dependence Service plays a crucial role in these complex pathological conditions, managing the gambling disorder and coordinating, at the same time, the network of territorial services, that is necessary to favor an optimal outcome.