A Review of Pharmacological Approaches to Intervention in Pathological Gambling

Abstract

ABSTRACT This article provides a brief overview of the development of pharmacological approaches in the treatment of problem or pathological gambling. The rationale for pharmacological approaches during those early stages of this form of intervention was based on attempts to simply block reinforcing affective “thrill” components inherent in gambling or on clinical judgment that drew analogies between the manifestations of repetitive gambling behavior and compulsions. Speculation that pathological gambling may be related to a dimension of impulsivity and obsessive-compulsive disorders prompted trials of medications shown to be efficacious with obsessive-compulsive disorder, such as the selective serotonin reuptake inhibitors. Other classes of medications such as opioid antagonists, mood stabilizers, and other antidepressants, have also shown promise in the treatment of pathological gambling. We conclude that pathological gambling may be a syndrome that includes features of affect instability, impaired cognitive control of impulses, and addiction.