Drug used to treat alcohol dependence also works for pathological gamblers

Jun 8 2008

Scientists in the U.S. have found that a drug commonly prescribed for the treatment of alcoholism and drug dependence, also works for pathological gamblers.

Pathological gambling is a disabling disorder affecting approximately 1% of adults with few tried and tested treatments.

Problem gambling or ludomania is an urge to gamble despite harmful negative consequences or a desire to stop - severe problem gambling is often referred to as pathological gambling and is characterised by many difficulties in limiting money and/or time spent on gambling with adverse consequences for the gambler, others, or for the community.

Pathological gambling (PG) is a recognized psychiatric disorder often defined as an impulse control disorder that is a chronic and progressive mental illness.

Pathological gambling involves;

• Frequent thoughts about gambling experiences, whether past, future, or fantasy, where larger or more frequent wagers are needed for the same level of excitement.

• Restlessness or irritability with attempts to cease or reduce gambling and gambling to improve mood or escape problems.

• Trying to win back gambling losses with more gambling and unsuccessful attempts to reduce gambling.

• Lying to conceal the extent of gambling and stealing to fund a gambling addiction.

• Breaking the law in order to obtain gambling money or recover gambling losses (theft, embezzlement, fraud, forgery, or bad checks).

• Gambling despite risking or losing a relationship, job, or other significant opportunity.

The scientists from the University of Minnesota in Minneapolis conducted a study using the drug naltrexone in 77 adults with PG, aged 14 to 59 years old, who gambled for 6 to 32 hours each week.

Fifty eight men and women were randomly assigned to take 50, 100, or 150 milligrams of naltrexone daily, for up to 18 weeks - while the other 19 individuals were given a placebo.

It was found that almost 40% of the pathological gamblers who took naltrexone were able to abstain from all gambling for at least 1 month, while just over 10% of those given the placebo were able to abstain.

Lead author Dr. Jon E. Grant says the majority of the study group reported symptoms of depression and about one-fifth said they had anxiety disorder, but at the time none had bipolar, psychotic, or substance abuse disorders.

Those treated with naltrexone, compared with placebo, reported fewer gambling urges and thoughts, and found they were better able to resist their urges to gamble; what is more, low doses of naltrexone were as effective as higher doses.

The researchers say that naltrexone is safe and well-tolerated for as long as 4 to 5 months, and helps to control the symptoms of pathological gambling.

The study is published in the Journal of Clinical Psychiatry.