Medication for Gambling Addiction

Currently, there are no medications that have been approved by the Food and Drug Administration to treat gambling addiction. While many medical trials have been small and short lived there are some promising studies involving antidepressants, mood stabilizers, and opioid antagonists. One day, it is possible that there will be a drug available to treat compulsive gambling. For now these drugs are only in the experimental stages. 

Gambling addiction is best treated by working with a specialized program or licensed therapist.

What is Pathological Gambling?

A gambling addiction, often called compulsive gambling, is the inability to resist the urge to gamble. Most often the disorder begins in adolescence for males and between 20 and 40 for women. 

To be diagnosed with a pathological gambling disorder 5 of 10 of the following criteria must be met. Additionally, the criteria must be met absent of any other disorder such as substance abuse or a manic episode associated with bipolar disorder.

1. Obsession with gambling (e.g., constantly thinking about past gambling experiences, planning future ventures, or seeking ways to acquire money for gambling).

2. Increasing need for larger amounts of money to experience the desired level of excitement from gambling.

3. Unsuccessful attempts to control, reduce, or quit gambling.

4. Restlessness or irritability when attempting to cut back or stop gambling.

5. Using gambling as an escape or coping mechanism to alleviate negative emotions or mood (e.g., helplessness, guilt, anxiety, depression).

6. Engaging in "chasing" behavior, where one returns to gamble again in order to recover previous losses.

7. Deceptive behavior, such as lying to loved ones, therapists, or others, in order to hide the extent of gambling involvement.

8. Resorting to illegal activities, such as forgery, fraud, theft, or embezzlement, to fund gambling habits.

9. Putting significant relationships, employment, education, or career opportunities at risk due to gambling-related issues.

10. Dependence on others to provide financial assistance in dire financial situations caused by gambling.

If 5 of 10 of these signs are met then an individual likely has a gambling disorder. Individuals may feel they have a gambling disorder even if they don’t meet the clinical definition. In either case, an individual should seek treatment.  

Potential Medications for Gambling Addiction

Gambling addiction is a lifelong struggle, there is no cure, and there is no quick fix. At this point there are no medications that can fully treat a gambling disorder. However, several different types of medication have been studied as potential treatments for compulsive gambling. Some types are serotonin reuptake inhibitors (SRIs), opioid antagonists, and mood stabilizers.

Opioid Antagonists

Gambling addiction and substance abuse issues are influenced by dopamine in the brain. Opioid antagonists inhibit dopamine release, thus reducing the thrill of gambling. One study found that patients given Naltrexone saw a reduction in gambling urges. The study also saw that patients with more severe gambling urges benefited more than patients with more mild forms of gambling urges.

Another opioid antagonist, nalmefene, saw similar results when compared to subjects taking a placebo. 

Antidepressants and Serotonin Reuptake Inhibitors (SRIs)

Researchers believe antidepressants will yield significant promise in treating gambling addiction as they target serotonin, which is associated with impulse control. Thus far, while some drugs showed promising results, they are not yet ready for approval by the FDA.

One study showed that escitalopram reduced gambling urges in individuals who had an anxiety disorder in addition to their gambling issues. 

Mood Stabilizers

Several studies have shown positive results for fluvoxamine in treating gambling disorders. For individuals who have a co-occurring disorder of bipolar disorder and gambling disorder, lithium has shown positive outcomes.

For patients who have an unrelated health issue or a co-occurring disorder, medications designed to curb gambling urges may not be an option as they’d interfere with their current treatment plans. Medication for gambling addiction should be considered only in conjunction with other forms of treatment. 

Medications That Can Cause Gambling

While some medications may reduce problem gambling or perhaps even provide some kind of cure, there are medications like abilify that can cause compulsive gambling. One study in Sweden showed that pramipexole, ropinirole, and aripiprazole could result in increased gambling urges. 

Pramipexole and ropinirole are both prescribed as treatment for restless leg syndrome (RLS). If prescribed these a person may be at high risk for developing a gambling problem. 

Finding Help

While medication for gambling addiction is promising and in some cases can show positive results, finding help for gambling addiction is a crucial step towards recovery and regaining control over one's life. Even with medication, treatment for gambling needs to be ongoing to address and underlying or co-occurring issues.

There are various avenues available for individuals seeking assistance. Support groups like Gamblers Anonymous offer a safe space to share experiences, receive guidance, and find strength in the community. Professional help is also essential, and therapists specializing in addiction can provide counseling and develop personalized treatment plans. 

Additionally, helplines and online resources dedicated to gambling addiction, such as hotlines and forums, offer immediate assistance and a wealth of information. Family and friends can be a valuable support system, providing encouragement and understanding. Taking the initiative to seek help demonstrates a commitment to change and sets the stage for a path towards recovery and a healthier future. Remember, help is available, and no one needs to face gambling addiction alone.

References:

• MedlinePlus: "Compulsive gambling” https://medlineplus.gov/ency/article/001520.htm

• PubMed Central: "The Biopsychosocial Consequences of Pathological Gambling” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004711/

• PubMed: "A pilot placebo-controlled study of fluvoxamine for pathological gambling" https://pubmed.ncbi.nlm.nih.gov/12046642/

• Yale Medicine: "Gambling Disorder" https://www.yalemedicine.org/conditions/gambling-disorder

• 800 Gambler: "Can Certain Medications Make Problem Gambling Worse?" https://800gambler.org/can-certain-medications-make-problem-gambling-worse/