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Pharmacological treatments in pathological gambling
Jon E Grant1, Brian L Odlaug, Liana R N Schreiber
1Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA.
British Journal of Clinical Pharmacology
|September 18, 2012
Summary
Opioid antagonists show promise as a first-line treatment for pathological gambling (PG), effectively reducing intense urges. Further research is needed to address limitations in current studies for pathological gambling treatment.
Area of Science:
- Psychiatry
- Pharmacology
- Behavioral Science
Background:
- Pathological gambling (PG) is a prevalent and disabling psychiatric condition.
- No formally approved pharmacotherapeutic interventions currently exist for PG.
- PG causes significant financial and personal devastation.
Purpose of the Study:
- To review the history of medication treatments for pathological gambling.
- To identify preferred medication choices for PG based on efficacy.
- To examine outcomes from double-blind, placebo-controlled pharmacotherapy studies.
Main Methods:
- Systematic review of 18 double-blind, placebo-controlled studies on PG pharmacotherapy.
- Documented study outcomes and mean medication doses.
- Analyzed various medication classes including antidepressants, antipsychotics, mood stabilizers, opioid antagonists, and glutamatergic agents.
Main Results:
- Antidepressants, atypical antipsychotics, and mood stabilizers showed mixed results.
- Opioid antagonists and glutamatergic agents demonstrated efficacy, particularly for intense gambling urges.
- Opioid antagonists are recommended as a first-line treatment for PG symptoms.
Conclusions:
- Opioid antagonists represent a promising first-line treatment for pathological gambling.
- Limitations include small sample sizes, short study durations, and potential non-representative clinical groups.
- Further research is required to identify factors influencing treatment response and advance PG treatment strategies.
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