Long-acting opioid antagonist may benefit pathological gamblers, study data suggest
Pathological addiction to gambling may respond to low doses of the long-acting opioid antagonist, nalmefene, according to a new study (American
Journal of Psychiatry 2006;163:
303).
Researchers in the US monitored a total of 207 outpatients over a period
of 12 months and found that urges/thoughts and behaviours towards gambling
were significantly reduced when treated with nalmefene 25mg daily.
The authors report that a similar drug, naltrexone, has shown some efficacy
in treating patients with alcohol and drug abuse — but that its
use is limited due to dose-dependent hepatotoxicity.
Patients with documented symptoms of pathological gambling (according
to DSM-IV criteria) were randomised to nalmefene (25mg/day, 50mg/day
and 100mg/day) or placebo during this 16-week, double blind, placebo-controlled
dose-ranging trial.
In terms of the primary outcome measure (total score on the Yale-Brown
Obsessive Compulsive Scale Modified for Pathological Gambling, a 10-item
clinician-administered scale used to rate gambling symptoms within the
previous seven days), there was a significant reduction difference favouring
nalmefene 25mg/day (from 14.01 at baseline to 6.99 at week 16; P=0.007
versus placebo).
The authors concluded: “Subjects who received nalmefene had a statistically
significant reduction in the severity of pathological gambling. Low-dose
nalmefene (25mg/day) appeared efficacious and was associated with few
adverse effects. Higher doses (50mg/day and 100 mg/day) resulted in intolerable
side effects”. |
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