The Cochrane database of systematic reviews

Drug treatments for gambling problems and gambling disorder

Updated

Abstract

Seventeen studies involving 1,193 participants were reviewed to assess various medications for gambling disorders.

  • Antidepressants showed no significant improvement compared to placebo in reducing gambling symptoms.
  • Opioid antagonists may provide a medium benefit for gambling symptom severity compared to placebo, but they did not improve responder status.
  • Mood stabilisers showed no improvement compared to placebo in gambling symptoms or related psychological issues.
  • Atypical antipsychotics may help reduce gambling symptoms compared to placebo.
  • Common side effects were reported for all medication types, with the highest discontinuation rates due to side effects seen in opioid antagonists.

Simplified

Funding

Competing interests

This review has not received financial support from any funding body. The authors have no conflicts of interest to declare in relation to this article. . Over the past three years, Nicki Dowling has received funding from multiple sources, including the Victorian Responsible Gambling Foundation, NSW Office of Responsible Gambling, Tasmanian Department of Treasury and Finance, Health Research Council of New Zealand, New Zealand Ministry of Health, Gambling Research Australia, International Center for Responsible Gambling, Ontario Problem Gambling Research Centre, and National Association for Gambling Studies (NAGS). She has had travel expenses paid by the Australian National University, PsychMed, and NSW Office of Responsible Gambling; payments or honoraria by the Victorian Responsible Gambling Foundation, University of Sydney, NSW Office of Responsible Gambling, Temple University, New York Council on Problem Gambling, Auckland University of Technology, and Canadian Centre on Substance Abuse; and other consultancies from the NSW Office of Responsible Gambling, Victorian Responsible Gambling Foundation, and ACT Gambling and Racing Commission. She is also affiliated with the University of Melbourne. She has not knowingly received research funding from the gambling, tobacco, or alcohol industries or any industry‐sponsored organisation. She has no conflicts of interest to declare in relation to this review. Over the past three years, Stephanie Merkouris has received funding from multiple sources, including government departments, the Victorian Responsible Gambling Foundation (through hypothecated taxes from gambling revenue) and the International Center for Responsible Gaming (ICRG), a charitable organisation that derives its funding through contributions from multiple stakeholder groups (with funding decisions the responsibility of an independent scientific advisory board). She is the recipient of a New South Wales Office of Responsible Gambling Postdoctoral Fellowship. She has not knowingly received research funding from the gambling industry or any gambling industry‐sponsored organisation, and has no conflicts of interest to declare. Over the past three years, Dan Lubman has provided consultancy advice to Indivior, and has received travel support and speaker honoraria from Camurus, Indivior, Janssen, Lundbeck, Shire, and Servier. He has not knowingly received research funding from the gambling industry or any gambling industry‐sponsored organisation, and has no conflicts of interest to declare. Over the past three years, Shane Thomas has received funding from Federation University, the Victorian Government, IBM, the Shenzhen Government, the International Institute for Primary Health Care Research in the PRC, the Australian Research Council, State Trustees, Accident Compensation Conciliation Service, and Australian National University. He has received no payments for involvement or expenses from the gambling industry or related entities. He has not received any funding from the gambling, alcohol, or pharmaceutical industries, and has no conflicts of interest to declare. Over the past three years, Henrietta Bowden‐Jones has been the recipient of both National Health Service (NHS) funding and GambleAware funding (the independent designated national charity distributing industry donations to treatment providers across England) for the National Problem Gambling Clinic. The National Centre for Gaming Disorders in the UK is funded only by the NHS, and the NHS Young People’s Gambling Treatment Services are also only funded by the NHS. She is the Director of all three centres and has never been the recipient of industry funding for clinical or research activities. Over the past three years, Sean Cowlishaw has received funding from the National Institute for Health Research (UK) and the Centre of Excellence on Post‐Traumatic Stress Disorder and Related Mental Health Conditions (Canada), as well as a range of Australian sources including the Australian Research Council, the National Health and Medical Research Council, the National Mental Health Commission, the Australian Government Department of Veterans Affairs, the Victorian Department of Education and Training, the Victorian Department of Health, the Defence Health Foundation and Weary Dunlop Foundation, as well as other philanthropic organisations including Colliers Charitable Fund, the Helen Macpherson Smith Trust, and Gandel Philanthropy. He has also received funding from the Victorian Responsible Gambling Foundation (involving hypothecated taxes on gambling revenue). He has participated in scholarly and policy‐related conferences and events that were sponsored by industry, but received no payment for involvement or expenses. He has not knowingly received funding from the gambling, alcohol, or pharmaceutical industries, and has no conflicts of interest to declare.
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