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

Assessed the efficacy and tolerability of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine (FLX) in the treatment of pathologic gambling (PG). A 16-wk randomized double-blind crossover design insured that each S received 8 wks of FLX and 8 wks of a placebo. Ten males (aged 24–56 yrs) completed the study. FLX 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 FLX and the placebo in the 2nd phase of the trial but not in the 1st. FLX side effects were of mild intensity and consistent with SSRI treatment. 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. (PsycInfo Database Record (c) 2021 APA, all rights reserved)