Bupropion in the treatment of pathological gambling - A randomized, double-blind, placebo-controlled, flexible-dose study
Bupropion in the treatment of pathological gambling - A randomized, double-blind, placebo-controlled, flexible-dose study
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DOI：
10.1097/01.jcp.0000264985.25109.25
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发表时间：
2007-04-01
影响因子：
2.9
通讯作者：
Allen, Jeff
中科院分区：
文献类型：
--
作者：
Black, Donald W.;Arndt, Stephan;Allen, Jeff
我们测试了安非他酮治疗病态赌博（PG）的疗效。在为期12周的双盲试验中，将患有精神障碍诊断和统计手册第四版PG的非抑郁健康受试者随机分配至安慰剂组或灵活剂量的安非他酮组。结果测量包括Yale-Brown强迫症量表（改良PG）、赌博严重程度评估量表、临床总体印象改善和严重程度量表、总体评估量表、时间轴随访、注意力缺陷/多动障碍评定量表和Sheehan残疾量表。39名受试者（28名男性，11名女性）被随机分配至安非他酮组（n = 18）或安慰剂组（n = 21）。两组的人口统计学和临床指标相似。治疗组之间在任何主要或次要结局指标上几乎没有差异，尽管每个单元中的受试者都有显著改善。在至少有1次随机化后访视的受试者中，35.7%的安非他酮组和47.1%的安慰剂组患者在临床总体印象改善量表上出现了“很大”或“非常大”的改善。试验因高未完成率（43.6%）而复杂化。安非他酮耐受性良好。安非他酮和安慰剂接受者在短期试验中表现同样好，早在治疗的第一周就有改善。高安慰剂应答率和高未完成率均反映了治疗PG患者的固有挑战。
We tested the efficacy of bupropion in the treatment of persons with pathological gambling (PG). Nondepressed, healthy subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PG were randomly assigned to placebo or flexibly dosed bupropion in a 12-week double-blind trial. Outcome measures included the Yale-Brown Obsessive-Compulsive Scale modified for PG, the Gambling Severity Assessment Scale, the Clinical Global Impression Improvement and Severity Scales, the Global Assessment Scale, the Timeline Follow Back, the Attention-Deficit/ Hyperactivity Disorder Rating Scale, and the Sheehan Disability Scale. Thirty-nine subjects (28 men, 11 women) were randomized to bupropion (n = 18) or placebo (n = 21). The 2 groups were similar on demographic and clinical measures. There were few differences between the treatment groups on any primary or secondary outcome measure, although subjects in each cell experienced significant improvement. Of subjects with at least 1 postrandomization visit, 35.7% of bupropion and 47.1% of placebo recipients experienced "much" or "very much" improvement on the Clinical Global Impression Improvement Scale. The trial was complicated by a high noncompletion rate (43.6%). Bupropion was well tolerated. Bupropion and placebo recipients did equally well in a short-term trial, with improvement seen as early as the first week of treatment. The high placebo response rate and the high noncompletion rate each reflect the challenge inherent in treating persons with PG.