title: Meta-analysis: pharmacological treatment of pathological gambling.
abstract: BACKGROUND
  This meta-analysis investigates the efficacy of pharmacological treatments for pathological gambling (PG).
  
  
  METHODS
  We searched for randomized, placebo-controlled trials examining pharmacotherapy of pathological gamblers. A fixed-effects model was used to calculate the standardized mean difference (SMD) of the benefit of medication (stratified by class) compared to placebo. Secondary analyses examined the effects of publication bias, year of publication and adherence to intention-to-treat (ITT) principles on reported efficacy of interventions.
  
  
  RESULTS
  Meta-analysis included 14 trials involving 1024 participants. Opiate antagonists demonstrated a small but significant benefit compared to placebo (SMD = 0.22 ± 0.10 (95% CI: 0.03-0.41), z = 2.3, p = 0.02). The reported efficacy of opiate antagonists was significantly associated with non-adherence to ITT principles in trials and earlier year of publication. Other medications had non-significant effect sizes compared to placebo but similar in magnitude to opiate antagonists.
  
  
  CONCLUSIONS
  Current trial data provides limited support for the use of any pharmacological agent in the treatment of pathological gambling.
authors: Connecticut Mental Health Center and the Child Study Center.
authors: Christine A
authors: CA
authors: Bartley
authors: Michael H
authors: MH
authors: Bloch
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D005715:Gambling / Q000188:drug therapy*; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D009271:Naltrexone; D009292:Narcotic Antagonists; D017367:Selective Serotonin Reuptake Inhibitors