Abstract
Background. Although there are no medications with indications for pathological gambling or gambling disorder, multiple pharmacotherapies and behavioral therapies have received empirical support in the treatment of pathological gambling or gambling disorder. Methods. Data from clinical trials will be reviewed, with an emphasis on findings from placebo-controlled, randomized clinical trials. Results. Both behavioral and pharmacological therapies appear efficacious in the treatment of gambling disorder. Behavioral therapies with varying degrees of empirical support include different forms of cognitive behavioral therapies, imaginal desensitization, motivational interviewing and brief interventions. Pharmacological therapies with varying degrees of support include opioid antagonists like naltrexone, mood stabilizers like lithium, serotonin reuptake inhibitors like paroxetine, and nutraceuticals like n-acetyl-cysteine. Recent data suggest that combinations of behavioral and pharmacological approaches hold promise and that co-occurring disorders may be used to guide selection of pharmacological agents. Conclusions. Although no medication currently has a formal indication for gambling disorder, multiple therapies have empirical support in the treatment of gambling disorder.
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