Pharmacotherapy of pathological gambling: review of new treatment modalities

Abstract

Pathological gambling is classified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition as an impulse-control disorder. In the International Classification of Diseases of the WHO, pathological gambling is coded under the heading of ‘Habit and Impulse Disorders’. Pathological gambling is a chronic, progressive disorder, which has a prevalence of 1–3.4% among western civilizations. The enormous personal and social consequences of this disorder include a high rate of suicide attempts, job loss, marital and family problems, legal problems, and criminal behavior. Recent studies have demonstrated that pathological gambling patients respond well to treatment with selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. These findings support the idea that pathological gambling and other disorders of impulse control may be conceptualized as part of the obsessive–compulsive spectrum disorders or addictive disorders. This article will discuss possible treatment strategies according to different behavior patterns in pathological gambling and also remind the physicians who intend to treat this disorder of the possible diagnosis of pathological gambling.

Keywords::

• addictive spectrum
• bupropion slow release
• impulsive spectrum
• mood stabilizers
• obsessive–compulsive spectrum
• opioid antagonists
• pathological gambling
• SSRI