Disulfiram, an option for the treatment of pathological gambling?
OBJECTIVE
Pathological gambling and comorbid alcohol dependence often occur in combination. Disulfiram is one of the proven drugs for alcohol dependence. In addition to its inhibiting acetaldehyde dehydrogenase, disulfiram inhibits dopamine beta-hydroxylase and may thereby increase dopamine and decrease norepinephrine cerebral concentrations. Because there may be common neurochemical substrates and neuronal circuits for pathological gambling and addiction, we wished to explore the effect of disulfiram in gambling.


METHODS
We describe the outcome of a patient with alcohol dependence and pathological gambling treated with disulfiram D.


RESULTS
During treatment with disulfiram, the patient reported that his desire to gamble disappeared entirely. Follow-up indicated that he has not gambled for >12 months.


CONCLUSIONS
Although uncontrolled case observations should be interpreted with caution, disulfiram deserves further investigation in pathological gambling.
Mutschler
Jochen
J
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Square J 5 68159 Mannheim, Germany. jochen.mutschler@puk.zh.ch
Bühler
Mira
M
Grosshans
Martin
M
Diehl
Alexander
A
Mann
Karl
K
Kiefer
Falk
F
D000427:Alcohol Deterrents / Q000009:adverse effects / Q000627:therapeutic use*; D000437:Alcoholism / Q000534:rehabilitation*; D001521:Behavior Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000534:rehabilitation*; D004221:Disulfiram / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D055502:Secondary Prevention; D013695:Temperance / Q000523:psychology
D000427:Alcohol Deterrents; D004221:Disulfiram