Pinhas N. Dannon^1,2. The 61st Annual Convention of the Society of Biological Psychiatry, Toronto, Canada, May 18th-20th, 2006
1. Psychiatry Dept, Rehovot Community Mental Health Care Clinic, Rehovot, Israel
2. Psychiatry Dept, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel

Background: Pathological Gambling (PG) is a relatively common and highly disabling impulse control disorder and treated with various medications. The aim of the study is to compare the effectiveness of sustained release (SR) bupropion versus naltrexone in the treatment of PG.

Methods: Thirty-six male PGs were enrolled in our study. A comprehensive psychiatric diagnostic evaluation was performed at baseline on all patients, and patients were screened for symptoms of gambling, depression, and anxiety using the South Oaks Gambling Screen, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Clinical Global Impression (CGI)-Severity Scale. Patients were randomized in two groups and received either naltrexone (N=19) or bupropion SR (N=17) for twelve weeks in a parallel fashion. Treatment response was monitored using the CGI- Improvement scale which was performed at weeks 2, 4, 8, and 12. Patients were also assessed for the presence of gambling behavior via an unstructured interview, which was also performed at weeks 2, 4, 6, 8, and 12.Raters were blind to the study treatment.

Results: Nine (75%) out of the twelve completers were rated as full responders in the sustained-release bupropion group versus ten (76%) of thirteen in the naltrexone group. 3/12 (25%) completers in the bupropion group were rated as partial responders. In naltrexone group 3/13 (23%) completers were rated as partial responders.

Conclusions: This preliminary study shows that bupropion SR may be effective as naltrexone in the treatment of pathological gambling.