ESCITALOPRAM IN THE TREATMENT OF PATHOLOGICAL GAMBLING

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。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，很少受到研究人员，政府或公众的关注。现在情况正在发生变化，因为很明显，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之外，美国的每个州都存在某种形式的合法赌博。1996年，美国各种形式的法律的赌博的赌注接近6000亿美元。据估计，PG每年给社会造成约50亿美元的损失，另外还有400亿美元的终身成本，用于降低生产力，社会服务和债权人损失。赌博业的增长和越来越频繁的PG导致了对个人和社会的不良影响的认识，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相关的问题，但很少有人关注开发适合PG患者需求的心理健康服务。关于PG的关键问题仍未得到回答，包括其适当的临床管理和对药理学试剂的反应。 我们建议用艾司西酞普兰治疗DSM-IV病理性赌博患者。艾司西酞普兰是市售的5-羟色胺再摄取抑制剂（SRI）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。因为其他SRI在治疗病理性赌博障碍方面表现出了希望，我们假设艾司西酞普兰也是有效的，耐受性良好。

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.