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A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling
E Hollander1, C M DeCaria, J N Finkell
1Department of Psychiatry and the Compulsive, Impulsive and Anxiety, Program, Mount Sinai School of Medicine, New York, New York 10029, USA.
Biological Psychiatry
|May 17, 2000
Summary
Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), shows promise for treating pathologic gambling (PG). This SSRI medication was well-tolerated and effective in an acute trial, reducing gambling severity and urge.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Pathologic gambling (PG) presents a significant clinical challenge.
- Selective serotonin reuptake inhibitors (SSRIs) are explored for potential therapeutic benefits in PG.
Purpose of the Study:
- To assess the efficacy and tolerability of fluvoxamine in treating pathologic gambling.
- To evaluate the impact of fluvoxamine on gambling severity, urge, and behavior.
Main Methods:
- A 16-week randomized, double-blind, crossover study design.
- Fifteen patients with PG were enrolled; 10 completed the study, receiving 8 weeks of fluvoxamine and 8 weeks of placebo.
- Standardized scales (PG-CGI, Yale-Brown Obsessive Compulsive Scale) were used for assessment.
Main Results:
- Fluvoxamine demonstrated a significant improvement in overall gambling severity (PG-CGI).
- A significant drug effect was observed on gambling urge and behavior.
- A notable interaction between drug effect and administration order was found, with significant benefits in the second trial phase.
Conclusions:
- Fluvoxamine is well-tolerated and potentially effective for acute treatment of PG.
- An early placebo effect in PG treatment appears to diminish over time.
- Further research with longer-term, parallel-design trials in diverse populations is recommended.