Table 1.
Double-blind placebo-controlled pharmacological treatment studies of impulse control disorders.
| Disorder (type of study) | Treatment | Outcome |
|---|---|---|
| ANTIDEPRESSANTS | ||
| Pathological gambling (DB); (Hollander et al., 2000) | Fluvoxamine (Luvox) | Fluvoxamine superior to placebo |
| Pathological gambling (DB); (Blanco et al., 2002) | Fluvoxamine (Luvox) | Fluvoxamine not statistically significant from placebo except in young males |
| Pathological gambling (DB); (Kim et al., 2002) | Paroxetine (Paxil) | Paroxetine group significantly improved compared to placebo |
| Pathological gambling (DB); (Grant et al., 2003) | Paroxetine (Paxil) | Paroxetine and placebo groups with comparable improvement |
| Pathological gambling (DB); (Grant and Potenza, 2006) | Escitalopram (Lexapro) | Significant improvement for escitalopram subjects while placebo group had a relapse of gambling symptoms |
| Pathological gambling (DB); (Sáaiz-Ruiz et al., 2005) | Sertraline (Zoloft) | Sertraline did not significantly differ from placebo |
| Pathological gambling (DB); (Black et al., 2007) | Bupropion (Wellbutrin) | Bupropion did not significantly differ from placebo. |
| Trichotillomania (DB); (Swedo et al., 1989) | Clomipramine (Anafranil) Desipramine (Norpramin) | Significant improvement with clomipramine compared to desipramine |
| Trichotillomania (DB); (Ninan et al., 2000b) | Clomipramine (Anafranil) | 67% of the clomipramine group were rated as “very much improved” on the CGI compared to none assigned to placebo. |
| Trichotillomania (DB); (O'Sullivan et al., 1999) | Fluoxetine (Prozac) Clomipramine (Anafranil) | Fluoxetine and clomipramine produced similar positive results |
| Trichotillomania (DB); (Christenson et al., 1991) | Fluoxetine (Prozac) | Fluoxetine produced no significant improvement compared to placebo |
| Trichotillomania (DB); (Streichenwein and Thornby, 1995) | Fluoxetine (Prozac) | Fluoxetine failed to show significant improvement compared to placebo |
| Trichotillomania (DB); (Van Minnen et al., 2003) | Fluoxetine (Prozac) | Fluoxetine did not demonstrate statistical superiority compared to waitlist or CBT |
| Kleptomania (OL and DB); (Koran et al., 2007a) | Escitalopram | Escitalopram did not significantly differ from placebo. |
| Intermittent explosive disorder (DB); (Coccaro et al., 2009) | Fluoxetine (Prozac) | Fluoxetine demonstrated superiority to placebo |
| Pathologic skin picking (DB); (Simeon et al., 1997) | Fluoxetine (Prozac) | Fluoxetine produced significant improvement compared to placebo |
| Pathologic skin picking (OL and DB); (Bloch et al., 2001) | Fluoxetine (Prozac) | 53.3% were rated as responders based on the YBOCS-–PSP in the OL. In the DB, only fluoxetine maintained improvement. |
| Pathological skin picking (DB); (Arbabi et al., 2008) | Citalopram (Celexa) | Citalopram was not statistically superior to placebo on a visual analogue scale. |
| Compulsive buying (DB); (Ninan et al., 2000a) | Fluvoxamine (Luvox) | Fluvoxamine and placebo groups with comparable improvement |
| Compulsive buying (DB); (Black et al., 2000) | Fluvoxamine (Luvox) | Fluvoxamine and placebo groups with comparable improvement |
| Compulsive buying (OL and DB); (Koran et al., 2003) | Citalopram (Celexa) | 63% were rated as responders in the OL. In the DB, 63% of the placebo group relapsed compared to none of those on citalopram. |
| Compulsive buying (OL and DB); (Koran et al., 2007b) | Escitalopram (Lexapro) | 73% of OL sample were rated as responders. 67% and 63% from the placebo and active medication group, respectively, relapsed during DB phase. |
| Compulsive sexual behavior (DB); (Wainberg et al., 2006) | Citalopram (Celexa) | Citalopram significantly reduced desire for sex, masturbation frequency, and weekly hours of pornography use compared to placebo. Sexual risk decreased in both groups, but no significant difference was found between groups. |
| MOOD STABILIZERS/ANTI-EPILEPTICS | ||
| Pathological gambling (DB); (Hollander et al., 2005) | Lithium carbonate SR (Lithobid SR) | Lithium produced significant improvement compared to placebo |
| Intermittent explosive disorder (DB); (Hollander et al., 2003) | Divalproex sodium (Depakote) | Significant changes seen in IED subjects who had a Cluster B personality disorder |
| Intermittent explosive disorder (DB); (Mattes, 2008) | Levetiracetam (Keppra) | Levetiracetam was not superior to placebo |
| Pathological skin picking (DB); (Grant et al., 2010) | Lamotrigine (Lamictal) | Lamotrigine did not significantly differ from placebo. Lamotrigine responders had impaired cognitive flexibility and delayed reach times at baseline compared to lamotrigine non-responders. |
| OPIOID ANTAGONISTS | ||
| Pathological gambling (DB); (Kim et al., 2001) | Naltrexone (ReVia) | Naltrexone group significantly improved compared to placebo |
| Pathological gambling (DB); (Grant et al., 2008). | Naltrexone (ReVia) | Naltrexone group significantly improved compared to placebo |
| Pathological gambling (DB); (Toneatto et al., 2009) | Naltrexone (ReVia) | Naltrexone group did not significantly differ from placebo |
| Pathological gambling (DB); (Grant et al., 2006) | Nalmefene (Revex) | Nalmafene resulted in significant improvement compared to placebo |
| Pathological gambling (DB); (Grant et al., 2010) | Nalmefene (Revex) | Nalmafene did not result in significant improvement compared to placebo in an intent-to-treat analysis; 40 mg resulted in significant improvement when only those who reached target dose were analyzed |
| Trichotillomania (DB); (O'Sullivan et al., 1999) | Naltrexone (ReVia) | Naltrexone significantly decreased TTM symptoms compared to placebo. |
| Kleptomania (DB); (Grant et al., 2009a) | Naltrexone (ReVia) | Naltrexone was statistically superior to placebo in reducing stealing behavior |
| ATYPICAL NEUROLEPTICS | ||
| Pathological gambling (DB); (Fong et al., 2008) | Olanzapine (Zyprexa) | Olanzapine did not significantly differ from placebo |
| Pathological gambling (DB); (McElroy et al., 2008) | Olanzapine (Zyprexa) | Olanzapine did not significantly differ from placebo |
| Trichotillomania (DB); (Van Ameringen et al., 2010) | Olanzapine (Zyprexa) | Olanzapine resulted in significant improvement compared to placebo |
| GLUTAMATERGIC AGENTS | ||
| Pathological gambling (OL and DB); (Grant et al., 2007a) | N-acetyl cysteine (NAC) | 59.3% of subjects were rated as responders in the OL. In the DB, 83.3% on NAC still met responder criteria at study endpoint compared to 28.6% on placebo. |
| Trichotillomania (DB); (Grant et al., 2009b) | N-acetyl cysteine (NAC) | NAC was statistically superior to placebo in reducing TTM symptoms. |
DB, double-blind study; OL, open-label study.