Short-term single-blind fluvoxamine treatment of pathological gambling.

OBJECTIVE The authors' goal was to assess the efficacy and tolerability of the selective serotonin reuptake inhibitor fluvoxamine in the treatment of pathological gambling. METHOD Sixteen patients with pathological gambling entered an 8-week placebo lead-in phase, and 10 of these patients completed an 8-week single-blind fluvoxamine trial. RESULTS Seven of the 10 patients who completed the fluvoxamine trial were judged treatment responders at the end of the study: 1) they had greater than 25% decreases in their gambling behavior scores on the pathological gambling modification of the Yale-Brown Obsessive Compulsive Scale, and 2) their clinician-rated Clinical Global Impression scores for gambling severity were very much improved or much improved. Fluvoxamine treatment resulted in gambling abstinence in seven of the 10 patients. CONCLUSIONS Findings from this preliminary study suggest that fluvoxamine may be effective in reducing the urge to gamble. Randomized placebo-controlled and maintenance trials are required to confirm these findings and to determine whether improvement persists.