A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling

Eric Hollander, Concetta M. Decaria, Jared N. Finkell, Tomer Begaz, Cheryl M. Wong, Charles Cartwright

Research output: Contribution to journalArticle

196 Citations (Scopus)

Abstract

Background: The study assessed the efficacy and tolerability of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine in the treatment of pathologic gambling (PG). Methods: A 16-week randomized double-blind crossover design insured that each subject received 8 weeks of fluvoxamine and 8 weeks of a placebo. Fifteen patients entered and 10 subjects, all male, completed the study. Results: Fluvoxamine resulted in a significantly greater percent improvement in overall gambling severity on the PG Clinical Global Impression (PG-CGI) scale. There was a significant drug effect on gambling urge and behavior as measured by the PG modification of the Yale-Brown Obsessive Compulsive Scale and PG-CGI scale improvement scores; however, there was a significant interaction of drug effect with the order of administration of drug and placebo. Post hoc analysis, treating each phase as a separate trial, demonstrated a significant difference between fluvoxamine and the placebo in the second phase of the trial but not in the first. Fluvoxamine side effects were of only mild intensity and consistent with SSRI treatment and were not associated with early withdrawal from the study. Conclusions: These findings suggest that fluvoxamine is well tolerated and may be effective in the treatment of PG in an acute trial, and that an early placebo effect in PG treatment appears to diminish over time. To confirm this finding and to determine whether improvement persists over an extended period of time, a longer duration parallel-design trial with long-term maintenance follow-up should be conducted in a larger and more diverse PG population. (C) 2000 Society of Biological Psychiatry.

Original languageEnglish (US)
Pages (from-to)813-817
Number of pages5
JournalBiological Psychiatry
Volume47
Issue number9
DOIs
StatePublished - May 1 2000
Externally publishedYes

Fingerprint

Fluvoxamine
Gambling
Cross-Over Studies
Placebos
Serotonin Uptake Inhibitors
Placebo Effect
Therapeutics
Drug Interactions
Pharmaceutical Preparations

Keywords

  • Compulsive
  • Fluvoxamine
  • Impulsivity
  • Pathologic gambling
  • Serotonin
  • SSRI

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling. / Hollander, Eric; Decaria, Concetta M.; Finkell, Jared N.; Begaz, Tomer; Wong, Cheryl M.; Cartwright, Charles.

In: Biological Psychiatry, Vol. 47, No. 9, 01.05.2000, p. 813-817.

Research output: Contribution to journalArticle

Hollander, Eric ; Decaria, Concetta M. ; Finkell, Jared N. ; Begaz, Tomer ; Wong, Cheryl M. ; Cartwright, Charles. / A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling. In: Biological Psychiatry. 2000 ; Vol. 47, No. 9. pp. 813-817.
@article{46c7e0478a734e29bd7b47a6a1a99574,
title = "A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling",
abstract = "Background: The study assessed the efficacy and tolerability of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine in the treatment of pathologic gambling (PG). Methods: A 16-week randomized double-blind crossover design insured that each subject received 8 weeks of fluvoxamine and 8 weeks of a placebo. Fifteen patients entered and 10 subjects, all male, completed the study. Results: Fluvoxamine resulted in a significantly greater percent improvement in overall gambling severity on the PG Clinical Global Impression (PG-CGI) scale. There was a significant drug effect on gambling urge and behavior as measured by the PG modification of the Yale-Brown Obsessive Compulsive Scale and PG-CGI scale improvement scores; however, there was a significant interaction of drug effect with the order of administration of drug and placebo. Post hoc analysis, treating each phase as a separate trial, demonstrated a significant difference between fluvoxamine and the placebo in the second phase of the trial but not in the first. Fluvoxamine side effects were of only mild intensity and consistent with SSRI treatment and were not associated with early withdrawal from the study. Conclusions: These findings suggest that fluvoxamine is well tolerated and may be effective in the treatment of PG in an acute trial, and that an early placebo effect in PG treatment appears to diminish over time. To confirm this finding and to determine whether improvement persists over an extended period of time, a longer duration parallel-design trial with long-term maintenance follow-up should be conducted in a larger and more diverse PG population. (C) 2000 Society of Biological Psychiatry.",
keywords = "Compulsive, Fluvoxamine, Impulsivity, Pathologic gambling, Serotonin, SSRI",
author = "Eric Hollander and Decaria, {Concetta M.} and Finkell, {Jared N.} and Tomer Begaz and Wong, {Cheryl M.} and Charles Cartwright",
year = "2000",
month = "5",
day = "1",
doi = "10.1016/S0006-3223(00)00241-9",
language = "English (US)",
volume = "47",
pages = "813--817",
journal = "Biological Psychiatry",
issn = "0006-3223",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling

AU - Hollander, Eric

AU - Decaria, Concetta M.

AU - Finkell, Jared N.

AU - Begaz, Tomer

AU - Wong, Cheryl M.

AU - Cartwright, Charles

PY - 2000/5/1

Y1 - 2000/5/1

N2 - Background: The study assessed the efficacy and tolerability of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine in the treatment of pathologic gambling (PG). Methods: A 16-week randomized double-blind crossover design insured that each subject received 8 weeks of fluvoxamine and 8 weeks of a placebo. Fifteen patients entered and 10 subjects, all male, completed the study. Results: Fluvoxamine resulted in a significantly greater percent improvement in overall gambling severity on the PG Clinical Global Impression (PG-CGI) scale. There was a significant drug effect on gambling urge and behavior as measured by the PG modification of the Yale-Brown Obsessive Compulsive Scale and PG-CGI scale improvement scores; however, there was a significant interaction of drug effect with the order of administration of drug and placebo. Post hoc analysis, treating each phase as a separate trial, demonstrated a significant difference between fluvoxamine and the placebo in the second phase of the trial but not in the first. Fluvoxamine side effects were of only mild intensity and consistent with SSRI treatment and were not associated with early withdrawal from the study. Conclusions: These findings suggest that fluvoxamine is well tolerated and may be effective in the treatment of PG in an acute trial, and that an early placebo effect in PG treatment appears to diminish over time. To confirm this finding and to determine whether improvement persists over an extended period of time, a longer duration parallel-design trial with long-term maintenance follow-up should be conducted in a larger and more diverse PG population. (C) 2000 Society of Biological Psychiatry.

AB - Background: The study assessed the efficacy and tolerability of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine in the treatment of pathologic gambling (PG). Methods: A 16-week randomized double-blind crossover design insured that each subject received 8 weeks of fluvoxamine and 8 weeks of a placebo. Fifteen patients entered and 10 subjects, all male, completed the study. Results: Fluvoxamine resulted in a significantly greater percent improvement in overall gambling severity on the PG Clinical Global Impression (PG-CGI) scale. There was a significant drug effect on gambling urge and behavior as measured by the PG modification of the Yale-Brown Obsessive Compulsive Scale and PG-CGI scale improvement scores; however, there was a significant interaction of drug effect with the order of administration of drug and placebo. Post hoc analysis, treating each phase as a separate trial, demonstrated a significant difference between fluvoxamine and the placebo in the second phase of the trial but not in the first. Fluvoxamine side effects were of only mild intensity and consistent with SSRI treatment and were not associated with early withdrawal from the study. Conclusions: These findings suggest that fluvoxamine is well tolerated and may be effective in the treatment of PG in an acute trial, and that an early placebo effect in PG treatment appears to diminish over time. To confirm this finding and to determine whether improvement persists over an extended period of time, a longer duration parallel-design trial with long-term maintenance follow-up should be conducted in a larger and more diverse PG population. (C) 2000 Society of Biological Psychiatry.

KW - Compulsive

KW - Fluvoxamine

KW - Impulsivity

KW - Pathologic gambling

KW - Serotonin

KW - SSRI

UR - http://www.scopus.com/inward/record.url?scp=0034194232&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034194232&partnerID=8YFLogxK

U2 - 10.1016/S0006-3223(00)00241-9

DO - 10.1016/S0006-3223(00)00241-9

M3 - Article

C2 - 10812040

AN - SCOPUS:0034194232

VL - 47

SP - 813

EP - 817

JO - Biological Psychiatry

JF - Biological Psychiatry

SN - 0006-3223

IS - 9

ER -