![]() material, see The main inclusion criterion at prescreening over telephone was a score of 5 or over in the South Oaks Gambling Screen-Revised (SOGS-R). Screening 236 persons recruited through advertisements in widely distributed free newspapers and announcements in gambling-related websites yielded 101 eligible participants (online suppl. Replication by larger scale studies is warranted to further evaluate naltrexone administration schedules for the treatment of PG and the role of OPRM1. Conclusion: Overall, the as-needed naltrexone may not provide substantial additional benefit for PG patients receiving psychosocial support. In an exploratory analysis, emotional well-being increased in a subgroup of participants with AA genotype of opioid receptor, mu 1 (OPRM1) A118G polymorphism (p = 0.02). Results: No significant treatment group differences were found. The results were analysed using the intention-to-treat principle and linear random effects modelling. In addition, RAND-36 scales of emotional well-being and social functioning were used as outcomes. Secondary gambling-related outcome measures included thoughts/urges and behaviour subscales of PG-YBOCS as well as the highest daily expenditure and gambling frequency. The primary outcome measure was the severity of PG assessed by the Yale-Brown Obsessive Compulsive Scale adapted for PG (PG-YBOCS). Methods: The participants (n = 101) received either as-needed placebo or naltrexone (50 mg) and psychosocial support for 20 weeks. The efficacy of as-needed naltrexone was assessed in a single-centre, randomised, double-blind, placebo-controlled trial. Pharmacological interventions for pathological gambling may be an adequate treatment alternative in pathological gambling.Background/Aims: Effective treatment strategies are needed for the treatment of pathological gambling (PG). No differences in outcome between the 3 main classes of pharmacological interventions (antidepressants, opiate antagonists, mood stabilizers) were detected. Effect sizes were also negatively related to the proportion of male participants in the included studies. A multiple regression analysis showed that the magnitude of effect sizes at posttreatment was lower in studies using a placebo-control condition compared with studies using a predesign/postdesign without any control condition. For each condition, means and SDs for gambling-related outcome measures were compiled at 2 points in time: baseline and posttreatment.Īt posttreatment, the analysis showed that the pharmacological interventions were more effective than no treatment/placebo, yielding an overall effect size of 0.78 (95% confidence interval, 0.64-0.92). The included studies were coded for outcome measures of pathological gambling. A total of 597 subjects were included in the outcome analyses of these studies. A total of 130 potential studies were identified of which 16 met the inclusion criteria. The inclusion criteria were as follows: the target problem had to be pathological gambling, the interventions were pharmacological, the study was written in English, and the study reported outcomes particularly pertaining to gambling. Studies of pharmacological interventions of pathological gambling were identified by computer searches in the PsychINFO and MEDLINE databases covering the period from 1966 to July 2006, as well as from relevant reference lists. Although several qualitative reviews on pharmacological interventions for pathological gambling have been published, no quantitative review of this field has been conducted.
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