The present study was designed to test the short-term efficacy and safety of
naltrexone in the treatment of
pathological gambling disorder. Seventeen subjects (seven men, 10 women) who fulfilled DSM-IV criteria for
pathological gambling disorder, and were free from other Axis I diagnoses by Structured Clinical Interview for DSM-III-R screening, participated in a 6-week open
naltrexone flexible dose trial.
Gambling symptom change was assessed with the patient-rated Clinical Global Impression (CGI) Scale, the clinician-rated CGI and the
Gambling Symptom Assessment Scale. Side-effects were monitored weekly and liver function tests biweekly.
Naltrexone reduced urges to gamble and
gambling behaviour. The mean change in
gambling frequency per week was 1.40 +/- 0.28 episodes per week; the mean change in dollars lost per week was $66.95 +/- 13.77; and the mean change in clinician-rated CGI Improvement was 0.40 +/- 0.04. Of those who responded to the medication, the majority had done so by the end of the fourth week. Men responded to
naltrexone as well as women. The average
naltrexone dose required for effective symptom control was 157 mg/day.
Nausea was common during the first week (47%). The present findings provide evidence that
naltrexone may be effective in the treatment of
pathological gambling disorder. The present report is preliminary and controlled trials are needed to confirm these findings.