An open-label study of citalopram in the treatment of pathological gambling
Zimmerman, M.; Breen, R.B.; Posternak, M.A.
Journal of Clinical Psychiatry 63(1): 44-48
2002
ISSN/ISBN: 0160-6689 PMID: 11838625 Document Number: 548187
Background: This study evaluated the effectiveness of citalopram in the treatment of pathological gambling. Method: Fifteen adult pathological gamblers (DSM-IV criteria) were administered citalopram in an open-label fashion for up to 12 weeks. Subjects were rated at baseline and at 2-week intervals on measures of gambling severity and depression, and monthly on quality of life. Results: Patients reported significant (p<.05) improvements on all gambling measures including the number of days gambled, the amount of money lost gambling, preoccupation with gambling, and urges to gamble. Thirteen (86.7%) of the patients were rated as "much improved" or "very much improved" on a clinician-rated Clinical Global Impressions scale for gambling. Patients reported improvement in depression and overall quality of life. Patients with major depressive disorder (MDD) (N=8) improved to approximately the same degree as patients without MDD (N=7). For most patients, clinical improvement occurred during the first 2 weeks of treatment; for the 9 patients who completed the entire 12-week trial, these gains were maintained. Conclusion: Citalopram appears to be an effective treatment for pathological gambling, and this benefit was independent of its antidepressant properties. Future studies employing a control group will be important to examine the extent of the response to nonspecific factors of treatment.