title: Treatment of pathological gambling with naltrexone pharmacotherapy and brief intervention: a pilot study.
abstract: We explored the efficacy of the opiate antagonist, naltrexone, as a treatment for pathological gambling. Treatment seeking pathological gamblers (n = 39) (according to both South Oaks Gambling Screen and a screen based on the Diagnostic and Statistical Manual of Mental Disorders) participated into our treatment study during 2009. The subjects were instructed to use 50 mg of naltrexone before gambling or when feeling craving towards gambling. The protocol contained one initial doctor visit with motivational brief intervention. During period that were free of gambling, the subjects were instructed to practice other healthy behavioral alternatives to gambling. The primary outcome measure was the Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling. The other outcome measurements were the EQ-5D quality of life survey, the Alcohol Use Disorders Identification Test, and the Beck Depression Inventory. The average age of the subjects was 39 years; 80% were men. Highly significant (p < 0.01) decreases in reported obsessive-compulsive gambling and depressive symptoms and increases in the subjective quality of life developed in the study. These positive changes suggest that this simple, inexpensive treatment helps pathological gamblers. The role of naltrexone in the treatment effect, however, needs to be determined with a larger, placebo-controlled study.
authors.affiliation: National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland. tuuli.lahti@thl.fi
authors.forename: Tuuli
authors.initials: T
authors.lastname: Lahti
authors.forename: Jukka T
authors.initials: JT
authors.lastname: Halme
authors.forename: Maiju
authors.initials: M
authors.lastname: Pankakoski
authors.forename: David
authors.initials: D
authors.lastname: Sinclair
authors.forename: Hannu
authors.initials: H
authors.lastname: Alho
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D005387:Finland; D005715:Gambling / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone