The B.C. Supreme Court recently dismissed a lawsuit brought by a woman against her former psychologist over prescription medication she claimed caused her to engage in “extreme and negative compulsive behaviour.”
JP brought the claim for damages against the defendant, Dr. Stephen Ogunremi, to the province’s superior trial court in the amount of approximately $1.2 million.
The reasons for judgment by Justice Stephens explain that JP began taking the prescription medication Abilify, as prescribed to her by her then psychiatrist Ogunremi, in November 2019.
JP alleged that Ogunremi “breached his standard of care” when prescribing her a 2 mg dose of the medication, also known by its pharmacological name Aripiprazole.
She also claimed that she wasn’t warned of the risks of a potential side effect of compulsive gambling and shopping, and was not monitored for that side effect by Ogunremi during follow-up a month later, when her prescription was refilled.
“She alleges that, as a result of taking that medication, she engaged in extreme and negative compulsive behaviour such as excessive gambling and shopping, that her life and personal relationships have been negatively impacted, her employment has been materially adversely affected, and that she has suffered damages,” wrote Stephens in his decision.
“Her evidence, and submissions at trial, especially emphasizes excessive gambling which she contends led to, among other things, significant financial losses and personal injury damages.”
The B.C. Supreme Court Justice also noted that JP experienced pre-existing mental health challenges and difficulties associated with opioid use at the time she was prescribed Abilify, and accepted that she believed that it caused her to engage in the compulsive activities.
However, Stephan explained that the legal proceeding concerned whether the plaintiff could demonstrate that the defendant faced legal liability because he allegedly didn’t warn of or monitor for compulsive behaviour and whether he complied with standard professional practice as to what side effects to mention.
The case would also hinge on whether JP could prove that the Abilify that Ogunremi prescribed was more likely than not to have caused her loss and damage to happen.
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According to the decision, Abilify was first approved in Canada in 2009 for the treatment of schizophrenia and related psychotic disorders 2009, and in 2013 for the treatment of major depressive disorder that was not responsive to antidepressants.
Justice Stephens also noted a 2015 Health Canada information update that announced that labels for Abilify have been updated to advise of an “increased risk of impulsive behaviours of pathological gambling and hypersexuality.”
“Health Canada also received five Canadian reports of pathological gambling and/or hypersexuality, but these contained limited information and therefore no conclusions could be made regarding what role, if any, the drugs may have played,” added the information update.
JP testified that in the five years before her initial prescription for Abilify, she would socially gamble in small amounts, and did not do so alone.
She told the plaintiff’s expert witness, Dr. Rosemary Abu, that she “never spent more than $100 at a sitting before” taking the medication. However, the court was shown banking records that contained withdrawals from casinos ranging from $400 to $600 in 2018.
JP claimed that she began gambling differently after her Abilify prescription, sneaking away from her family to gamble by herself, play slot machines, and spend between $10,000 and $20,000. She said that she would also lie about it to her family.
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“The plaintiff contends that, while taking Abilify, she withdrew approximately $186,000 at casinos over the course of 25 casino visits, during a roughly eight-week period (the significant majority of which being in the latter half of this time period).”
“The plaintiff also testified that she had an urge to shop, and did so excessively. For example, she would buy 10 pairs of the same shoes with slightly different colours, and bought multiple high-end bags and purses. She testified at one time, she had 25 Louis Vuitton bags. She testified she had never shopped like that before.”
The B.C. Supreme Court also heard from JP that if she had known that Abilify could cause pathological gambling disorder, she would have stopped it right away and reported the side effects to a doctor.
She continued taking the prescription medication until an appointment at an Opioid Agonist Treatment (OAT) clinic, where she told a doctor that she had been gambling and shopping and didn’t know why. JP also revealed to the doctor that she had banned herself from B.C. casinos.
According to Stephen’s decision, Ogunremi submitted that JP “cannot establish causation,” arguing, “there is no indication that, ‘but for’ taking Abilify, the plaintiff would not have gone on to experience these same compulsive behaviours.”
The psychiatrist testified that he told JP that Abilify was effective and that the commonly reported side effects included headache, anxiety, and restlessness. He also said that it can very rarely cause compulsive disorder.
“He testified he did not discuss compulsive gambling or a risk of gambling. He testified that his understanding was that there was not a strong association between gambling and Abilify, and if a patient has an established gambling disorder, it might come up, but not in this case. He did not inquire as to her gambling history.”
The B.C. Supreme Court Justice ultimately agreed with the defendant, finding that the plaintiff did not demonstrate a breach of the standard of care or causation when applying the law of negligence to the trial evidence.
“I find the defendant followed a standard professional practice of not mentioning a risk of compulsive gambling when prescribing the plaintiff the low 2 mg dose of Abilify in the circumstances (which practice was not itself negligent),” wrote Justice Stephens.
“I also find that the plaintiff has not demonstrated that it is more likely than not that Abilify was the cause of her increased gambling and shopping activity in any event. Accordingly, the action should be dismissed.”