Lahti Tuuli, Halme Jukka T, Pankakoski Maiju, Sinclair David, Alho Hannu
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland.
Psychopharmacol Bull. 2010;43(3):35-44.
We explored the efficacy of the opiate antagonist, naltrexone, as a treatment for pathological gambling. Treatment seeking pathological gamblers (n = 39) (according to both South Oaks Gambling Screen and a screen based on the Diagnostic and Statistical Manual of Mental Disorders) participated into our treatment study during 2009. The subjects were instructed to use 50 mg of naltrexone before gambling or when feeling craving towards gambling. The protocol contained one initial doctor visit with motivational brief intervention. During period that were free of gambling, the subjects were instructed to practice other healthy behavioral alternatives to gambling. The primary outcome measure was the Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling. The other outcome measurements were the EQ-5D quality of life survey, the Alcohol Use Disorders Identification Test, and the Beck Depression Inventory. The average age of the subjects was 39 years; 80% were men. Highly significant (p < 0.01) decreases in reported obsessive-compulsive gambling and depressive symptoms and increases in the subjective quality of life developed in the study. These positive changes suggest that this simple, inexpensive treatment helps pathological gamblers. The role of naltrexone in the treatment effect, however, needs to be determined with a larger, placebo-controlled study.
我们探究了阿片类拮抗剂纳曲酮作为病理性赌博治疗方法的疗效。寻求治疗的病理性赌博者（n = 39）（根据南橡树赌博筛查量表以及基于《精神疾病诊断与统计手册》的筛查标准）于2009年参与了我们的治疗研究。受试者被指示在赌博前或感到有赌博冲动时服用50毫克纳曲酮。该方案包括一次初始的医生问诊及动机性简短干预。在无赌博期间，受试者被指示练习其他替代赌博的健康行为方式。主要结局指标是适用于病理性赌博的耶鲁布朗强迫量表。其他结局测量指标包括EQ - 5D生活质量调查问卷、酒精使用障碍识别测试以及贝克抑郁量表。受试者的平均年龄为39岁；80%为男性。研究中报告的强迫性赌博和抑郁症状显著减少（p < 0.01），主观生活质量提高。这些积极变化表明这种简单、廉价的治疗方法对病理性赌博者有帮助。然而，纳曲酮在治疗效果中的作用需要通过更大规模的安慰剂对照研究来确定。
