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Marc N. Potenza, MD, PhD, Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06517, 203-974-7356, marc.potenza@yale.edu
Compared to other neuropsychiatric disorders of comparable prevalence and impact, relatively little research has been performed into the biological basis and treatment of pathological gambling. Recent genetic, neuroimaging and clinical trial studies have begun to identify mechanisms underlying pathological gambling and effective treatments for the disorder. This presentation will review major findings, focusing on results from large twin investigations, functional magnetic resonance imaging studies, and placebo-controlled, double-blind, randomized drug treatment trials. Genetic models have estimated the environmental and genetic contributions to pathological gambling and related disorders, and these data suggest shared genetic contributions to pathological gambling and related disorders such as alcohol dependence and anti-social behaviors. Functional magnetic resonance imaging studies suggest relatively decreased activity in ventromedial prefrontal cortex in individuals with pathological gambling, a brain region previously implicated in impaired impulse control and disadvantageous decision-making in bipolar and substance use disorders. Although no drugs are FDA-approved for the treatment of pathological gambling, randomized, placebo-controlled, double-blind, short-term trials of serotonin reuptake inhibitors, opioid antagonists and mood stabilizers suggest efficacy and tolerability. Implications for current treatment of individuals with pathological gambling and future research directions will be explored.
Learning Objectives:
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Off-label drug treatment will be described
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Grants from GlaxoSmithKline, Oy Contral, Biotie, Forest, Ortho McNeil