Extended release carbamazepine in the treatment of pathological gambling: an open-label study

The efficacy and tolerability of extended release carbamazepine was tested in the treatment of pathological gambling (PG).

Non-depressed outpatients with DSM-IV PG received flexibly dosed extended release carbamazepine in a prospective 10-week open-label trial following a two-week observation period. Subjects were evaluated at baseline and at one week intervals during a four week titration period, and every two weeks thereafter for assessment of gambling behavior, mood, and adverse experiences. The primary efficacy measure was the Yale-Brown Obsessive-Compulsive Scale modified for PG (YBOCS-PG).

Eight subjects (6 men, 2 women) had at least one post-baseline visit, and five subjects (63%) completed the protocol. Significant improvement was found on the YBOCS-PG (P< .001). Seven of the eight subjects with post-baseline assessment (88%) were considered responders (i.e., achieved "much" or "very much" improvement on the CGI). Four subjects (50%) abstained from gambling during their final month of study participation. Several patients were dropped because of adverse experiences.

The results suggest that extended release carbamazepine may be effective in the treatment of PG.