Table 7.
Summary of Naltrexone (NTX) Efficacy and Safety in Adult Trials for Gambling and Other Behavioral Disorders
| Reference | Sample Size (Study Design) | Disease: Dosing and Duration | Outcomes |
|---|---|---|---|
| Ward171 | 14 (case series) | “Problem gamblers” – NTX: 50 mg/day | Gambling behavior/urge: − ≥83% SAE: none |
| Bosco172 | 3 (case series) | Pathologic gambling in Parkinson disease – NTX: 50 mg/day for 6–8 mo | Remission of pathologic gambling: 100% SAE: none |
| Grant173 | 25 (PCT) | Kleptomania – NTX: Titrate up to 150 mg/day for 8 wk | K-YBOCS: NTX: 3.83 (CV = 75%); PLB: 11.46 SAE: none |
| Grant174 | 77 (PCT) | Pathologic gambling – NTX: Up to 150 mg/day for 18 wk | PG-YBOCS: NTX: 9.7 (CV = 84%); PLB: 12.9 Abstinent at 1 mo: NTX: 40%; PLB: 11% SAE: none |
| Kovanen175 | 101 (PCT) | Pathologic gambling – NTX: 50 mg as needed (advised to take if urge to gamble or 30–60 min prior to gambling) for 20 wk | PG-YBOCS: NTX: 10.3 (CV = 74%); PLB: 13.1 SAE: none |
| Papay176 | 50 (PCT) | Impulsive compulsive disorder in Parkinson disease – NTX: 50–100 mg/day for 8 wk | QUIP-RS ICD Δ: NTX: −14.9 (95% CI: −9.9 to −19.9); PLB, −7.5 SAE: none |
| Grant177 | 51 (PCT) | Trichotillomania – NTX: up to 150 mg/day for 8 wk | MGH-PHS score: NTX: 12.2 (CV = 51%); PLB: 13.6 SAE: none |
| Toneatto178 | 52 (PCT) | Alcohol abusing and pathologic gambling – NTX: up to 250 mg/day for 11 wk (following 1-wk placebo run-in) | Gambling frequency: NTX: 11.4 (CV = 101%); PLB: 10.8 SAE: none |
CV, coefficient of variation; K-YBOCS, Yale-Brown Obsessive Compulsive Scale adapted for Kleptomania; MGH-PHS score, Massachusetts General Hospital Hair-Pulling Scale; PCT, placebo-controlled trial; PG-YBOCS, Yale-Brown Obsessive Compulsive Scale adapted for Pathological Gambling; PLB, placebo; QUIP-RS ICD: Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale; SAE, serious adverse event