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An Open-Label Study of Citalopram in the Treatment of Pathological Gambling

Mark Zimmerman, M.D.; Robert B. Breen, Ph.D.; and Michael A. Posternak, M.D.

Background: This study evaluated the effectiveness of citalopram in the treatment of pathological gambling.

Method: Fifteen adult pathological gamblers (DSM-IV criteria) were administered citalopram in an open-label fashion for up to 12 weeks. Subjects were rated at baseline and at 2-week intervals on measures of gambling severity and depression, and monthly on quality of life.

Results: Patients reported significant (p<.05) improvements on all gambling measures including the number of days gambled, the amount of money lost gambling, preoccupation with gambling, and urges to gamble. Thirteen (86.7%) of the patients were rated as "much improved" or "very much improved" on a clinician-rated Clinical Global Impressions scale for gambling. Patients reported improvement in depression and overall quality of life. Patients with major depressive disorder (MDD) (N=8) improved to approximately the same degree as patients without MDD (N=7). For most patients, clinical improvement occurred during the first 2 weeks of treatment; for the 9 patients who completed the entire 12-week trial, these gains were maintained.

Conclusion: Citalopram appears to be an effective treatment for pathological gambling, and this benefit was independent of its antidepressant properties. Future studies employing a control group will be important to examine the extent of the response to nonspecific factors of treatment.

(J Clin Psychiatry 2002;63:44-48)

Received Jan. 15, 2001; accepted July 9, 2001. From the Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, R.I.

Supported in part by a grant from Forest Pharmaceuticals.

Reprint requests to: Mark Zimmerman, M.D., Bayside Medical Center, 235 Plain St., Providence, RI 02905.