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Heroin Addiction and Related Clinical Problems: 2013, 15, 3 (pages: 47 - 54)

Successful long-term (3-year) treatment of gambling with naltrexone. A case report

Piz L., Maremmani A. G. I., Rovai L., Bacciardi S., Rugani F., and Maremmani I.

Summary: Pathological gambling (PG) is classified as an impulse control disorder in the Diagnosis and Statistical Manual of Mental Disorder (DSM-IV-TR). There is still no properly validated pharmacotherapeutic treatment of PG. The involvement of the mu-opioid system in reward processes leads to the hypothesis that opioid antagonists have an impact on addictive behaviours. In reality, opioid antagonists have been used not only in substance abuse illnesses (narcotics, alcohol), but also in a variety of psychiatric conditions, including anorexia nervosa, bulimia, schizophrenia, self-injurious behaviour autism, obsessive-compulsive disorder, Tourette's disease and trichotillomania. We present a case report in which an Italian patient affected by pathological gambling was successfully given long-term treatment with naltrexone. Controlled studies on opiate antagonists from the literature have already shown positive results. This case report confirms these data, but the present innovative finding is, for the first time, focused on the long-term outcome of treatment without side-effects. The patient has, in fact, taken her medication for 3 years, and so far she has never relapsed into gambling.