title: A double-blind, placebo-controlled trial of topiramate for pathological gambling.
abstract: OBJECTIVE
  Pathological gambling (PG) is an impulse control disorder characterized by recurrent gambling thoughts and behaviours that impair social functioning. Earlier studies suggested that topiramate may be effective in treating some impulse control disorders. We conducted the first randomized, controlled trial of topiramate in PG.
  
  
  METHODS
  PG patients were randomized to topiramate (N = 20) or placebo (N = 22) in this 14-week, double-blind, placebo-controlled, parallel-group trial. The primary outcome measure was change in the obsessions subscale of the Yale-Brown Obsessive-Compulsive Scale Modified for Pathological Gambling.
  
  
  RESULTS
  Mixed regression models (time [weeks] × treatment) revealed no significant treatment effect of topiramate on the primary or secondary outcome measures. The most statistically robust findings involved reducing the Barratt Impulsiveness Scale (BIS) total score and Motor and Non-Planning subscale scores, for which topiramate outperformed placebo at merely a trend level (P < 0.1).
  
  
  CONCLUSIONS
  The observed trend in BIS score reductions may warrant further investigation to study whether topiramate reduces clinically important impulsivity in PG. Treatment studies with larger samples and less stringent exclusion criteria are needed to produce results that can be generalized to pathological gamblers in the community.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. heather.berlin@mssm.edu
authors.forename: Heather A
authors.initials: HA
authors.lastname: Berlin
authors.forename: Ashley
authors.initials: A
authors.lastname: Braun
authors.forename: Daphne
authors.initials: D
authors.lastname: Simeon
authors.forename: Lorrin M
authors.initials: LM
authors.lastname: Koran
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
authors.forename: Susan L
authors.initials: SL
authors.lastname: McElroy
authors.forename: Timothy
authors.initials: T
authors.lastname: Fong
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D016903:Drug Monitoring; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005715:Gambling / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D000077236:Topiramate; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose