ESCITALOPRAM IN THE TREATMENT OF PATHOLOGICAL GAMBLING

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。病态赌博（PG）已经成为一个重大的公共卫生问题，直到最近，很少受到研究人员、政府或公众的关注。这种情况现在正在改变，因为PG的流行正在增加，特别是随着合法赌博的激增。现在，除了夏威夷和犹他州，每个州都有某种形式的合法赌博；1996年，美国在各种形式的合法赌博中下注近6000亿美元。据估计，PG每年给社会造成约50亿美元的损失，并在生产力下降、社会服务和债权人损失方面额外造成400亿美元的终身成本。随着博彩业的发展和PG的日益频繁，人们已经意识到它对个人和社会的不良影响，包括犯罪行为、抑郁、药物滥用、家庭暴力和自杀。然而，尽管存在广泛的赌博相关问题，但很少有人关注针对PG患者需求的心理健康服务。关于PG的关键问题仍未得到解答，包括其适当的临床管理和对药物的反应。我们建议用艾司西酞普兰治疗患有DSM-IV病理性赌博的人。艾司西酞普兰是市面上销售的5 -羟色胺再摄取抑制剂（SRIs）之一，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SRIs在治疗病理性赌博障碍方面已经显示出前景，我们假设艾司西酞普兰也将是有效且耐受性良好的。

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.