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

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

  1. 1. 12 Placebo 20mg 40mgPG-YBOCS Urges 10 8 p=.027 6 4 2 4 6 8 10 Visit
  2. 2. 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
  3. 3. Analysis of Maximum Likelihood Estimates (N=282)Variable Parameter Standard Chi- Pr>ChiSq Hazard Estimate Error Square RatioFH-AUD 0.55 0.24 7.53 0.006 1.74Baseline urges were significantly associated with response tohigher doses of opiate antagonists (i.e. nalmefene 50mg or100mg 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
  4. 4. N-Acetyl Cysteine: 12-Week Open-Label56% reduction in urges; 57% reduction in total gamblingsymptoms
  5. 5. Visit 1 Visit 6 p-valuePG-YBOCS totalscore 21.8 8.9 <.001Responder, n (%) n/a 18 <.001 (62.1)Dollars lost per week 743 309 <.001Hours gambled perweek 10.4 4.0 <.001
  6. 6. PG B v E PG B v C PG E v C T P t p t pIDED total 2.20 0.037 2.09 0.041 1.06 0.294errors
  7. 7. Lexapro Treatment of Anxious Gamblers
  8. 8. * * ** p<.05 Hollander et al, 2002

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