An Open-Label Trial of Escitalopram in the Treatment of Pathological Gambling

Abstract

The effectiveness and tolerability of escitalopram was tested in the treatment of pathological gambling (PG). Nondepressed outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PG received flexibly dosed escitalopram in a prospective, 10-week, open-label trial after a 2-week observation period. Subjects were evaluated at baseline and at 2-week intervals for assessment of gambling behavior, mood symptoms, and adverse experiences. The primary efficacy measure was the Yale-Brown Obsessive-Compulsive Scale modified for PG. Secondary efficacy measures included the Clinical Global Impression (CGI) Improvement and Severity Scales, a patient self-rated global rating, the Sheehan Disability Scale, and the Timeline Follow Back. Nineteen subjects (12 men and 7 women) had at least 1 postbaseline visit and were included in the analysis; 16 subjects (84%) completed the protocol. Significant improvement was found in all measures, including the Yale-Brown Obsessive-Compulsive Scale modified for PG, both CGI Scales, a patient self-rated global scale, the Timeline Follow Back, the Attention-Deficit/Hyperactivity Disorder Checklist, the Hamilton Depression Rating Scale, and all 3 Sheehan Disability Scale subscales. Fourteen subjects (73.7%) were considered responders (ie, achieved "much" or "very much" improvement on the CGI). Few adverse experiences were reported. The results suggest that escitalopram is well tolerated and may be effective in the treatment of PG.