An open-label trial of escitalopram in the treatment of pathological gambling

Background: The effectiveness and tolerability of escitalopram was tested in the treatment of pathological gambling (PG). Method: Nondepressed outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PG received flexibly dosed escitalopram in a prospective, 10-week, open-label trial after a 2-week observation period. Subjects were evaluated at baseline and at 2-week intervals for assessment of gambling behavior, mood symptoms, and adverse experiences. The primary efficacy measure was the Yale-Brown Obsessive-Compulsive Scale modified for PG. Secondary efficacy measures included the Clinical Global Impression (CGI) Improvement and Severity Scales, a patient self-rated global rating, the Sheehan Disability Scale, and the Timeline Follow Back. Results: Nineteen subjects (12 men and 7 women) had at least 1 postbasefine visit and were included in the analysis; 16 subjects (84%) completed the protocol. Significant improvement was found in all measures, including the Yale-Brown Obsessive-Compulsive Scale modified for PG, both CGI Scales, a patient self-rated global scale, die Timeline Follow Back, the Attention-Deficit/Hyperactivity Disorder Checklist, the Hamilton Depression Rating Scale, and all 3 Sheehan Disability Scale subscales. Fourteen subjects (73.7%) were considered responders (ie, achieved "much" or "very much" improvement on the CGI). Few adverse experiences were reported. Conclusion: The results suggest that escitalopram is well tolerated and may be effective in the treatment of PG.