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The Treatment of Pathologic Gambling

Brewer, Judson A. MD, PhD*; Grant, Jon E. MD, JD, MPH; Potenza, Marc N. MD, PhD* ‡

Addictive Disorders & Their Treatment: March 2008 - Volume 7 - Issue 1 - p 1-13
doi: 10.1097/ADT.0b013e31803155c2
Original Articles

Objective To review evidence-based behavioral and pharmacologic therapies in the treatment of pathologic gambling (PG).

Methods Available literature was reviewed and results of behavioral and pharmacologic treatment studies were summarized and evaluated.

Results Multiple behavioral and pharmacologic therapies have been studied in the treatment of PG. Compared with no treatment, several types of behavioral treatments seem beneficial in the treatment of PG. For those who attend, self-help programs seem helpful. Among pharmacotherapies, selective serotonin reuptake inhibitors have shown mixed results whereas opioid antagonists have shown more consistent efficacy, although fewer studies have been performed with these agents. Other pharmacotherapies have shown preliminary positive results.

Summary Multiple behavioral and pharmacologic therapies have been studied and show promise in the treatment of PG. Larger studies with longer follow-up are needed. Treatments targeting specific subpopulations of people with PG will likely refine and enhance efficacies of specific therapies, and standardized outcome measures should improve comparisons of interventions across studies.

*Department of Psychiatry, Yale University School of Medicine, New Haven, CT

Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN

Veterans Affairs Connecticut Healthcare Systems, West Haven, CT

Reprints: Marc N. Potenza, MD, PhD, Yale University School of Medicine, 34 Park Street, New Haven, CT (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.