Antidepressants may curb urge to gamble

Serena Gordon

Monday, June 11, 2001 | 11:09 a.m.

Compulsive gamblers may soon be betting on a new treatment for their addiction -- antidepressant medication.

Thirteen of 15 compulsive gamblers who took the antidepressant Celexa in a Brown University study reported they gambled less and had fewer urges to gamble.

"At the start of the study, the gamblers were averaging almost $1,900 in gambling losses in the two weeks prior to the initial assessment. At our last follow-up, that was down to $145 in the past two weeks," says one of the study's authors, Robert Breen, associate director of the Rhode Island Gambling Treatment Program at Rhode Island Hospital, which is affiliated with Brown University.

Pathological gambling may affect more than 3 percent of the U.S. population, the study says. The addiction shares many similarities with obsessive-compulsive disorders.

The 15 men and women in study were ready to stop their pathological gambling, the researchers say. Most gambled on slot or video poker machines. Their average gambling debt was $30,564 and their age average was 44. All were from the Providence area.

The patients were given Celexa, an antidepressant in a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), and were asked to report to the researchers every two weeks over three months.

Breen says some participants reported improvement at their first appointment, suggesting a placebo effect because the drugs take several weeks to become effective. But he says improvements over three months showed the added benefit of the drug.

Several participants reported sexual side effects, such as impotence and the inability to achieve orgasm, Breen says.

By the end of the study, 13 of the 15 subjects (87 percent) reported spending less money and fewer days gambling. They also reported fewer problems with gambling urges.

Breen says he's not sure how Celexa works for compulsive gambling; however he says other SSRIs have helped control disorders such as compulsive shopping and kleptomania.

Dr. Norman Sussman, a clinical associate professor of psychiatry at New York University School of Medicine, says Celexa and other SSRIs help compulsive gamblers because the drugs shut down pathways in the brain that allow gamblers to feel a "rush" when they gamble.

"Gambling, like many other behaviors we consider compulsive, can be treated with medications," says Sussman. But he says the success rate would probably not be as high in real life as it was in the study.

The study, sponsored by Forest Laboratories, the maker of Celexa, was presented to the National Institute for Mental Health's New Clinical Drug Evaluation Unit last week in Phoenix.