pathologic gambling; compulsive gambling

Etiology

• associated with alcoholism & tobaccoism
• high incidence of depression, bipolar disorder, psychosis, anxiety disorder, personality disorder, substance abuse (including alcohol & tobacco), ADHD
• behavioral disturbances & personality changes of early dementia
• boredom:
  • older adults are more likely than younger adults to cite relief from boredom as a reason for gambling

Epidemiology

• 1-2% of population with pathologic gambling
• older persons less likely to gamble than younger persons

Management

• screen for alcohol abuse, tobacco use & other substance abuse disorders
• no medication helpful in reducing pathologic gambling
  • pharmacotherapy most effective when targeting comorbid condition
• selective serotonin reuptake inhibitor (SSRI)
• concurrent bipolar disorder
  • divalproex
  • lithium carbonate
• naltrexone (ReVia) has not been shown to decrease the urge to gamble

More general terms

• impulse control disorder