[Pharmacotherapy for patients with a gambling disorder: a systematic review].

BACKGROUND

There are currently no registered medicines available for the treatment of gambling disorder.

AIM: To describe the evidence about medication for gambling disorder.

METHOD: We conducted a systematic review of the effectiveness of medication for gambling disorder in Medline, Embase, and PsycInfo. Due to methodological differences between the studies no meta-analysis could be performed.

RESULTS

We included 24 double-blind, randomized trials with a total of 1,547 patients, analyzing the effect on gambling disorder of opioid antagonists, antidepressants, antipsychotics, mood stabilizers, anti-epileptics, glutamate modulators and phytotherapy. In 21 studies active medication was compared to placebo and in three studies two active medications were compared. Of the seven studies about opioid antagonists, four reported significantly better results than placebo. A positive effect was seen less frequently with the other drugs.

CONCLUSION

Due to the limited evidence, only patients who do not respond to psychotherapeutic interventions might be considered for off-label treatment with an opioid antagonist such as naltrexone or nalmefene. For all other medications investigated, there is currently insufficient evidence of effectiveness in treating gambling disorder.