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An open-label study of citalopram in the treatment of pathological gambling
Mark Zimmerman1, Robert B Breen, Michael A Posternak
1Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI, USA.
Background:
This study evaluated the effectiveness of citalopram in the treatment of pathological gambling.
Method:
Fifteen adult pathological gamblers (DSM-IV criteria) were administered citalopram in an open-label fashion for up to 12 weeks. Subjects were rated at baseline and at 2-week intervals on measures of gambling severity and depression, and monthly on quality of life.
Results:
Patients reported significant (p < .05) improvements on all gambling measures including the number of days gambled, the amount of money lost gambling, preoccupation with gambling, and urges to gamble. Thirteen (86.7%) of the patients were rated as "much improved" or "very much improved" on a clinician-rated Clinical Global Impressions scale for gambling. Patients reported improvement in depression and overall quality of life. Patients with major depressive disorder (MDD) (N = 8) improved to approximately the same degree as patients without MDD (N = 7). For most patients, clinical improvement occurred during the first 2 weeks of treatment; for the 9 patients who completed the entire 12-week trial, these gains were maintained.
Conclusion:
Citalopram appears to be an effective treatment for pathological gambling, and this benefit was independent of its antidepressant properties. Future studies employing a control group will be important to examine the extent of the response to nonspecific factors of treatment.
