A Double-Blind Placebo-Controlled Study of the Efficacy and Safety of Paroxetine in the Treatment of Pathological Gambling
Suck Won Kim, Jon E. Grant, David E. Adson, Young Chul Shin, and Rocco Zaninelli
J Clin Psychiatry 2002;63(6):501-507
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: This randomized,
double-blind, placebo-controlled study investigated the
efficacy and tolerability of paroxetine in the treatment
of pathological gambling.
Method: Patients fulfilling DSM-IV
criteria for pathological gambling and scoring 5 on
the South Oaks Gambling Screen were enrolled if no other Axis I disorder was present. A 1-week
placebo run-in phase was followed by 8 weeks'
treatment with paroxetine or placebo. The initial paroxetine dose of 20 mg/day could be
increased after week 2 by 10 mg/week to a maximum of
60 mg/day. Changes in clinical status were
assessed using the Gambling Symptom Assessment
Scale (G-SAS) and the Clinical Global Impressions scale (CGI). Treatment-emergent symptoms
were assessed weekly.
Results: Forty-five patients were included
in an intent-to-treat analysis (N=23 paroxetine, N=22 placebo). Statistically significantly
greater reductions in the total score of the G-SAS
were observed in the paroxetine group compared
with the placebo group at weeks 6 through 8
(p=.003, .003, and .042, respectively). Improvement on
the CGI was also significantly greater in the
paroxetine than in the placebo group at the same
timepoints (p=.033, .014, and .025, respectively).
A significantly greater proportion of patients in
the paroxetine group were responders at weeks 7
and 8 (p=.011 and .010, respectively).
Conclusion: The results of this trial
indicate that paroxetine may be effective in the
treatment of pathological gambling. There were no
unexpected side effects from this treatment.
However, additional studies with larger patient samples
and a longer treatment phase are required to
establish conclusively the efficacy and safety of
paroxetine for this indication.