title: Disulfiram, an option for the treatment of pathological gambling?
abstract: 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.
authors.affiliation: 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
authors.forename: Jochen
authors.initials: J
authors.lastname: Mutschler
authors.forename: Mira
authors.initials: M
authors.lastname: Bühler
authors.forename: Martin
authors.initials: M
authors.lastname: Grosshans
authors.forename: Alexander
authors.initials: A
authors.lastname: Diehl
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
authors.forename: Falk
authors.initials: F
authors.lastname: Kiefer
mesh_terms: 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
chemical_list: D000427:Alcohol Deterrents; D004221:Disulfiram