TY - JOUR
T1 - Nefazodone treatment of pathological gambling
T2 - A prospective open-label controlled trial
AU - Pallanti, Stefano
AU - Rossi, Nicolò Baldini
AU - Sood, Erica
AU - Hollander, Eric
PY - 2002/11
Y1 - 2002/11
N2 - Background: Pathological gambling is a disabling and highly prevalent impulse-control disorder not otherwise specified (NOS). According to the hypothesis of abnormal serotonin function in the pathophysiology of poor impulse control and pathological gambling, we assessed the efficacy and tolerability of nefazodone, a 5-HT antagonist reported to be effective in other impulse-control disorders NOS, in the treatment of pathological gambling. Method: Fourteen outpatients who met DSM-IV criteria for pathological gambling were enrolled in a prospective 8-week open-label oral nefazodone trial. Nefazodone was initiated at 50 mg/day and titrated upward to a maximum of 500 mg/day based on patient's response and side effects, with a minimum daily dose of 100 mg. Improvement in gambling was assessed via the pathological gambling modifications of the Yale-Brown Obsessive Compulsive Scale (PG-YBOCS), the Clinical Global Impressions-Improvement scale (PG-CGI-I), and self-rated gambling scales. Response was defined a priori as both a 25% reduction in PG-YBOCS score and a score of 1 (very much improved) or 2 (much improved) on the PG-CGI-I scale. Results: Twelve subjects completed the study, and 2 subjects were early dropouts who did not receive the minimum required dose. Significant improvements were noted in all gambling outcome measures, as well as in depression and anxiety ratings (which did not significantly correlate with gambling reduction). Nine (75%) of 12 patients were rated as responders according to a priori criteria. Side effects (dry mouth and sedation) of moderate severity occurred in 4 subjects. Conclusion: These preliminary results suggest that nefazodone may be effective in reducing symptoms of pathological gambling and is well tolerated.
AB - Background: Pathological gambling is a disabling and highly prevalent impulse-control disorder not otherwise specified (NOS). According to the hypothesis of abnormal serotonin function in the pathophysiology of poor impulse control and pathological gambling, we assessed the efficacy and tolerability of nefazodone, a 5-HT antagonist reported to be effective in other impulse-control disorders NOS, in the treatment of pathological gambling. Method: Fourteen outpatients who met DSM-IV criteria for pathological gambling were enrolled in a prospective 8-week open-label oral nefazodone trial. Nefazodone was initiated at 50 mg/day and titrated upward to a maximum of 500 mg/day based on patient's response and side effects, with a minimum daily dose of 100 mg. Improvement in gambling was assessed via the pathological gambling modifications of the Yale-Brown Obsessive Compulsive Scale (PG-YBOCS), the Clinical Global Impressions-Improvement scale (PG-CGI-I), and self-rated gambling scales. Response was defined a priori as both a 25% reduction in PG-YBOCS score and a score of 1 (very much improved) or 2 (much improved) on the PG-CGI-I scale. Results: Twelve subjects completed the study, and 2 subjects were early dropouts who did not receive the minimum required dose. Significant improvements were noted in all gambling outcome measures, as well as in depression and anxiety ratings (which did not significantly correlate with gambling reduction). Nine (75%) of 12 patients were rated as responders according to a priori criteria. Side effects (dry mouth and sedation) of moderate severity occurred in 4 subjects. Conclusion: These preliminary results suggest that nefazodone may be effective in reducing symptoms of pathological gambling and is well tolerated.
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U2 - 10.4088/JCP.v63n1114
DO - 10.4088/JCP.v63n1114
M3 - Article
C2 - 12444818
AN - SCOPUS:0036854259
SN - 0160-6689
VL - 63
SP - 1034
EP - 1039
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 11
ER -