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2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
12




                                          Placebo
                                          20mg
                                          40mg
PG-YBOCS Urges

                 10
                 8




                                           p=.027
                 6
                 4
                 2




                      4   6           8       10


                              Visit
1.0	


                           .9	


                           .8	

                                                 Naltrexone /	

Proportion Nonrelapsed



                                                                                 Asp40 Allele (A/G, G/G)	

                           .7	

                                                                                 Naltrexone 	

                           .6	

                                                 Asn40 Allele (A/A)	


                           .5	

                                                 Placebo /	

                                                                                 Asp40 Allele (A/G, G/G)	

                           .4	

                                                 Placebo /	

                                                                                 Asn40 Allele (A/Al)	

                           .3	


                           .2	


                           .1	


                         0.0	

                              0	

   14	

   28	

     42	

   56	

   70	

   84	


                                                     Days
Analysis of Maximum Likelihood Estimates
                    (N=282)

Variable    Parameter   Standard Chi-   Pr>ChiSq Hazard
            Estimate    Error    Square          Ratio


FH-AUD      0.55        0.24       7.53    0.006      1.74


Baseline urges were significantly associated with response to
higher doses of opiate antagonists (i.e. nalmefene 50mg or
100mg or naltrexone 100mg or 150mg) (parameter estimate =
1.77; SE= 0.84; Wald 2 =4.41; p= .036; HR= 5.86; HR 95%
CI=1.12-30.6
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
N-Acetyl Cysteine: 12-Week Open-Label




56% reduction in urges; 57% reduction in total gambling
symptoms
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
Visit 1 Visit 6   p-value

PG-YBOCS total
score                21.8    8.9       <.001

Responder, n (%)     n/a     18        <.001
                             (62.1)
Dollars lost per week 743    309       <.001
Hours gambled per
week                 10.4    4.0       <.001
PG B v E     PG B v C     PG E v C


             T      P     t      p     t    p

IDED total
             2.20   0.037 2.09   0.041 1.06 0.294
errors
Lexapro Treatment of Anxious Gamblers
*
              *
                  *




* p<.05
                      Hollander et al, 2002
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)
2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)

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2010 Conference - Toward a Treatment Standard for Pathological Gambling (Grant)

  • 13. 12 Placebo 20mg 40mg PG-YBOCS Urges 10 8 p=.027 6 4 2 4 6 8 10 Visit
  • 14. 1.0 .9 .8 Naltrexone / Proportion Nonrelapsed Asp40 Allele (A/G, G/G) .7 Naltrexone .6 Asn40 Allele (A/A) .5 Placebo / Asp40 Allele (A/G, G/G) .4 Placebo / Asn40 Allele (A/Al) .3 .2 .1 0.0 0 14 28 42 56 70 84 Days
  • 15. Analysis of Maximum Likelihood Estimates (N=282) Variable Parameter Standard Chi- Pr>ChiSq Hazard Estimate Error Square Ratio FH-AUD 0.55 0.24 7.53 0.006 1.74 Baseline urges were significantly associated with response to higher doses of opiate antagonists (i.e. nalmefene 50mg or 100mg or naltrexone 100mg or 150mg) (parameter estimate = 1.77; SE= 0.84; Wald 2 =4.41; p= .036; HR= 5.86; HR 95% CI=1.12-30.6
  • 18. N-Acetyl Cysteine: 12-Week Open-Label 56% reduction in urges; 57% reduction in total gambling symptoms
  • 22. Visit 1 Visit 6 p-value PG-YBOCS total score 21.8 8.9 <.001 Responder, n (%) n/a 18 <.001 (62.1) Dollars lost per week 743 309 <.001 Hours gambled per week 10.4 4.0 <.001
  • 23. PG B v E PG B v C PG E v C T P t p t p IDED total 2.20 0.037 2.09 0.041 1.06 0.294 errors
  • 24. Lexapro Treatment of Anxious Gamblers
  • 25. * * * * p<.05 Hollander et al, 2002