Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling.

Abstract

BACKGROUND:

The authors' goal was to assess the efficacy and tolerability of naltrexone in the treatment of pathologic gambling disorder.

METHODS:

Eighty-three subjects who met criteria for DSM-IV pathologic gambling disorder were enrolled in a 1-week single-blind placebo lead-in followed by an 11-week double-blind naltrexone or placebo trial. Naltrexone was started at 25 mg/day and titrated upward until maximum symptom improvement or 250 mg/day was achieved. Gambling symptom change was assessed with the patient-rated Clinical Global Impression (PG-CGI-PT), clinician-rated CGI (PG-CGI-MD), and the Gambling Symptom Rating Scale (G-SAS). Side effects were monitored weekly and liver function tests biweekly.

RESULTS:

Data from 45 patients were analyzed. Using random regression analysis, significant improvement was noted in all three gambling symptom measures: patient-rated Clinical Global Impression, p <.001; clinician-rated CGI, p <.001; Gambling Symptom Rating Scale, p <.019. At study end, 75% of subjects taking naltrexone were much or very much improved on both the PE-CEI PT and the PG-CGI-MD, compared with only 24% of those on placebo. Elevated liver enzymes occurred in four subjects who were taking analgesics concurrently. Nausea was common during the first week of treatment.

CONCLUSIONS:

Results suggest that naltrexone is effective in reducing the symptoms of pathologic gambling. Until further studies corroborate the present findings, our report should be interpreted cautiously.

• Authors: S W Kim, J E Grant, D E Adson, Y C Shin
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 49 Issue 11 Pg. 914-21 (Jun 01 2001) ISSN: 0006-3223 [Print] United States
• PMID: 11377409 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Narcotic Antagonists
• Naltrexone

Topics

• Adolescent
• Adult
• Aged
• Disruptive, Impulse Control, and Conduct Disorders (diagnosis, drug therapy, psychology)
• Double-Blind Method
• Gambling (psychology)
• Humans
• Interview, Psychological
• Liver Function Tests
• Middle Aged
• Naltrexone (therapeutic use)
• Narcotic Antagonists (therapeutic use)
• Single-Blind Method
• Surveys and Questionnaires