1. A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling
- Author
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Hannu Alho, Sirkku T. Saarikoski, Maiju Pankakoski, Leena Kovanen, Syaron Basnet, Sari Castrén, Timo Partonen, and Tuuli Lahti
- Subjects
Adult ,Male ,medicine.medical_specialty ,Health (social science) ,Narcotic Antagonists ,Placebo-controlled study ,Receptors, Opioid, mu ,Medicine (miscellaneous) ,Placebo ,Polymorphism, Single Nucleotide ,Naltrexone ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Internal medicine ,medicine ,Humans ,Young adult ,Pathological ,ta515 ,Aged ,Alcohol dependence ,Middle Aged ,Combined Modality Therapy ,030227 psychiatry ,Psychiatry and Mental health ,Treatment Outcome ,Opioid ,Gambling ,Psychotherapy, Brief ,Female ,Psychology ,030217 neurology & neurosurgery ,medicine.drug ,Clinical psychology - Abstract
Background/Aims: Effective treatment strategies are needed for the treatment of pathological gambling (PG). The efficacy of as-needed naltrexone was assessed in a single-centre, randomised, double-blind, placebo-controlled trial. Methods: The participants (n = 101) received either as-needed placebo or naltrexone (50 mg) and psychosocial support for 20 weeks. The primary outcome measure was the severity of PG assessed by the Yale-Brown Obsessive Compulsive Scale adapted for PG (PG-YBOCS). Secondary gambling-related outcome measures included thoughts/urges and behaviour subscales of PG-YBOCS as well as the highest daily expenditure and gambling frequency. In addition, RAND-36 scales of emotional well-being and social functioning were used as outcomes. The results were analysed using the intention-to-treat principle and linear random effects modelling. Results: No significant treatment group differences were found. In an exploratory analysis, emotional well-being increased in a subgroup of participants with AA genotype of opioid receptor, mu 1 (OPRM1) A118G polymorphism (p = 0.02). Conclusion: Overall, the as-needed naltrexone may not provide substantial additional benefit for PG patients receiving psychosocial support. Replication by larger scale studies is warranted to further evaluate naltrexone administration schedules for the treatment of PG and the role of OPRM1.
- Published
- 2016