DIAGNOSIS, NEUROBIOLOGY, AND TREATMENT OF PATHOLOGICAL GAMBLING

Pathological gambling is a disabling disorder that affects at least 2 1/2 million Americans and their families. Although pathological gambli ng has been characterized as an impulse control disorder, it has also been associated with compulsivity. Essential features of pathological gambling include constantly recurring gambling behavior that is malada ptive, in that personal, familial, and/or vocational endeavors are dis rupted. Affective disorders and substance abuse often co-occur. Incide nce of suicidality is extremely high. Despite the fact that this disor der is a widespread public health problem, few controlled studies of c auses or treatment have been conducted. Preliminary neurobiological st udies implicate serotonergic dysfunction in pathological gamblers. Tre atment with serotonin reuptake inhibitors, such as clomipramine and fl uvoxamine, may be effective in treating this disorder. Well-defined an d controlled clinical trials in large samples of pathological gamblers are needed.