A new review article from the principal investigators of the NCRG Centers of Excellence in Gambling Research at Yale University and the University of Minnesota explores the potential of pharmacological treatments for disordered gambling in adolescents. It is important to identify an effective treatment for this age group, as adolescents are at a higher risk for developing gambling-related problems than adults. However, no drug trials focused on pathological gambling have been conducted with this age group. Determining which drugs might be safe, tolerable and effective for adolescents is more complex than simply applying what we already know about pharmacological treatments for adults (Grant & Potenza, 2010).
Currently, there are no pharmacological treatments approved by the U.S. Food and Drug Administration (FDA) for pathological gambling, though several drugs have shown potential in this area. One medication that has performed well in clinical trials is naltrexone, which has been used to blunt cravings for alcohol. Several studies suggest that naltrexone can reduce the intensity of gambling urges among adults with pathological gambling. Naltrexone is currently approved by the FDA as a treatment for alcohol dependence, and has been used in small doses to treat adolescents.
Lithium, currently used to treat bipolar disorder, is another medication with potential. It has been shown to reduce thoughts and urges associated with pathological gambling in people with both bipolar spectrum disorders and pathological gambling. One attribute that makes lithium particularly appealing is that it has been used safely with adolescents to treat bipolar disorder.
According to the authors, it is difficult to translate pharmacological treatments to adolescents because the adolescent brain is “a changing organ” (Grant & Potenza, 2010, p. 129). That is, the brain’s developmental processes may cause a drug to affect adolescents differently than adults depending on their individual stage of maturation. Consequently, research on adults can only suggest potentially promising pharmacological treatments. Definitive treatment recommendations for adolescents will have to wait for the completion of clinical trials in this population that include a control group for comparison.
More information on NCRG Centers of Excellence in Gambling Research is available on the Institute’s website. As always, we welcome your thoughts and questions in the Comments section below.
References
Grant, J. E., & Potenza, M. N. (2010). Pharmacological treatment of adolescent pathological gambling. International Journal of Adolescent Medicine and Health, 22(1), 129-138.
