Lithium and valproate treatment of pathological gambling: a randomized single-blind study

The aim of the present study was to evaluate the efficacy and safety of lithium and valproate in nonbipolar pathological gamblers.

Forty-two subjects with DSM-IV-defined pathological gambling entered a 14-week single-blind trial with lithium (N = 23) or valproate (N = 19). A total of 15 subjects on lithium treatment and 16 patients on valproate treatment completed the 14-week protocol.

At the end of the 14-week treatment period, both the lithium and the valproate groups showed significant (p <.01) improvement in mean score on the Yale-Brown Obsessive Compulsive Scale modified for pathological gambling. This improvement did not significantly differ between groups. Fourteen (60.9%) of the 23 patients taking lithium and 13 (68.4%) of the 19 patients taking valproate were responders based on a Clinical Global Impressions-Improvement score of much or very much improved.

Findings from the present study suggest the efficacy of both lithium carbonate and valproate in the treatment of pathological gambling. This is the first controlled trial of the efficacy of mood stabilizers in pathological gambling. A double-blind, placebo-controlled trial is required to confirm these findings.