ESCITALOPRAM IN THE TREATMENT OF PATHOLOGICAL GAMBLING

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。病理性赌博(PG)已经成为一个重要的公共卫生问题，直到最近，一直没有受到研究人员、政府和公众的关注。现在情况正在改变，因为PG的流行已经变得明显，特别是在赌博合法化激增的情况下。除了夏威夷和犹他州，现在每个州都存在某种形式的合法赌博；1996年，美国所有形式的合法赌博都下注了近6000亿美元。据估计，PG每年给社会造成约50亿美元的损失，以及因生产率下降、社会服务和债权人损失而额外产生的400亿美元的终身成本。赌博业的发展和PG频率的增加使人们意识到其对个人和社会的不利影响，包括犯罪行为、抑郁症、药物滥用、家庭暴力和自杀。然而，尽管存在广泛的与赌博有关的问题，但很少有人关注发展针对PG患者需求的精神健康服务。关于PG的关键问题仍未得到回答，包括其适当的临床处理和对药理药物的反应。我们建议用艾司西普兰治疗患有DSM-IV病理性赌博的人。艾司匹兰是一种上市的5-羟色胺再摄取抑制剂(SRIs)，已被证明在治疗抑郁症、恐慌症和强迫症方面安全有效。由于其他SRI已经显示出在治疗病理性赌博障碍方面的前景，我们假设爱西他普兰也将是有效的和良好的耐受性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pathological Gambling (PG) has become a significant public health problem which, until recently, has received little attention from researchers, the government, or the general public. The situation is now changing as it has become clear that the prevalence of PG is increasing, particularly as legalized gambling has proliferated. Some form of legalized gambling now exists in every state except Hawaii and Utah; in 1996 nearly $600 billion was wagered in all forms of legal gambling in the United States. PG is estimated to cost society about $5 billion per year and an additional $40 billion in lifetime costs for reduced productivity, social services, and creditor losses. The growth of the gambling industry and the increasing frequency of PG has led to an awareness of its adverse effects on individuals and society including criminal behavior, depression, substance abuse, domestic abuse and suicide. yet, despite extensive gambling related problems, little attention has been directed at developing mental health services geared at the needs of a person with PG. Critical questions about PG remain unanswered including its appropriate clinical management and response to pharmacological agents. We propose to treat persons with DSM-IV pathological gambling with escitalopram. Escitalopram is one of the marketed Serotonin Reuptake Inhibitors (SRIs) and has been shown to be safe and effective in the treatment of depression, panic and OCD. Because other SRIs have shown promise in treating Pathological Gambling Disorder, we hypothesize that Escitalopram will also be effective and well tolerated.