Objective: The authors' goal was to assess the efficacy and tolerability of
the selective serotonin reuptake inhibitor fluvoxamine in the treatment of
pathological gambling. Method: Sixteen patients with pathological gambling
entered an 8-week placebo lead-in phase, and 10 of these patients complete
d an 8-week single-blind fluvoxamine trial. Results: Seven of the 10 patien
ts who completed the fluvoxamine trial were judged treatment responders at
the end of the study: 1) they had greater than 25% decreases in their gambl
ing behavior scores on the pathological gambling modification of the Yale-B
rown Obsessive Compulsive Scale, and 2) their clinician-rated Clinical Glob
al Impression scores for gambling severity were very much improved or much
improved. Fluvoxamine treatment resulted in gambling abstinence in seven of
the 10 patients. Conclusions: Findings from this preliminary study suggest
that fluvoxamine may be effective in reducing the urge to gamble. Randomiz
ed placebo-controlled and maintenance trials are required to confirm these
findings and to determine whether improvement persists.