Promising early results in a study of a medication to treat kleptomania

Researchers at Stanford University School of Medicine are reporting promising early results in a study of a medication to treat kleptomania.

More volunteers are needed for the confidential 24-week trial that, the researchers say, has curbed the urge to steal in the majority of patients who have entered the study so far.

“The preliminary results from the first patients to go through the study are even better than we expected,” said Elias Aboujaoude, MD, a clinical instructor in the Department of Psychiatry and Behavioral Sciences and one of the study investigators. “What we have seen so far is very impressive, with 78 percent of the patients responding to the drug in the open-label phase.” The open-label phase is when trial participants are aware that they are taking a particular drug and not a placebo.

Kleptomania, the guilt-ridden, impulsive stealing of inexpensive and unneeded items, often goes untreated as many who suffer from the disorder hesitate to seek help out of fear of being turned in for their illegal activities. More than 1.2 million people in the United States are thought to suffer from kleptomania. The condition differs from shoplifting, in which the action is usually planned, guilt-free and motivated by need or monetary gain. Kleptomania appears to affect more women than men, and the age of onset often dates back to childhood or adolescence.

Although the cause of kleptomania remains unknown, some researchers believe it involves disruptions of the brain neurotransmitter, serotonin. Earlier studies have suggested that a class of medications known as selective serotonin reuptake inhibitors, or SSRIs, can be effective in treating disorders with similar aspects, such as compulsive skin picking or compulsive shopping.

Lorrin Koran, MD, the professor of psychiatry and behavioral sciences who is leading the study, said it is the first double-blind, placebo-controlled test of a medication to treat kleptomania: in this instance, the study is researching the effect of the SSRI escitalopram, which is marketed as Lexapro and has been approved by the Food and Drug Administration for treating major depressive disorder.

The study is funded by Forest Laboratories, the company that makes Lexapro. Koran and Aboujaoude have both served as paid speakers for Forest Laboratories.

For the first seven weeks of the study, all participants receive Lexapro. Those who respond favorably to the drug, as defined by a decrease of at least 50 percent in thefts, and who tolerate it well are then randomly assigned to either continue with the active drug or switch to a placebo for the next 17 weeks. Neither the patients nor the clinicians know who is taking what after randomization.

Participants who suffer a relapse, as defined by an increase in thefts to more than 50 percent of the starting level, are taken out of the study and have the option to resume drug treatment.

Volunteers age 20 or older who think they may have kleptomania are encouraged to call the Obsessive-Compulsive and Related Disorders Research Program at (650) 725-5180 for a confidential assessment for possible participation in the study. At least 12 in-office interviews will be required over the 24 weeks of the study.