MEDICINE TO CURB GAMBLING LOOKS LIKE A GOOD BET

Mike Ambrose, a computer-systems analyst, often would spend 36 hours
straight on weekends playing slot machines until his paycheck was gone.

After blowing $15,000 to $20,000 a year on his habit for more than a
decade, Ambrose, in desperation, volunteered as a patient in a clinical
study to test a drug to control his gambling urge.

The medication, naltrexone, originally devised to combat heroin addiction
and alcoholism, changed his life. Within two weeks, the Fridley, Minn., man
noticed a "tremendous difference - suddenly, the urges stopped."

Three years later, Ambrose, 60, still takes a maintenance dose of the drug.
"Naltrexone takes all the excitement out of it, and I don't get the rush
anymore," he said.

The final results of this study conducted at the University of Minnesota
were reported earlier this month in the journal Biological Psychiatry. The
study found that people who took naltrexone reported that their gambling
urges - once so powerful that they stole from their children and even
turned to prostitution to pay gambling debts - either vanished or were
diminished enough that they could resist temptation.

Brain malfunction

The Minnesota research is among a handful of recent studies suggesting that
the gambling urge has its roots in biology, rather than human frailty.

Researchers say that gambling may be, at least in part, sparked by a short
circuit in the brain's wiring or an imbalance in key brain chemicals. And
drugs such as naltrexone, which blocks the brain's pleasure pathways, are
helping people control their impulses.

The findings offer new hope to the estimated 1 percent to 3 percent of the
population that suffers from a gambling addiction, for which there is no
standard treatment.

The University of Minnesota experiment, for example, involved 45 compulsive
gamblers. For 11 weeks, 20 people received naltrexone, which dulls the
sensation of pleasure that is associated with addictive cravings. The
remainder were given a placebo, or dummy pill.

Each week, participants were interviewed about the severity of their
symptoms, the frequency and duration of their urges, the time they were
consumed with thoughts about gambling and the time they actually spent
gambling.

Three-quarters of those on the medication reported substantial relief from
the compulsion that had seriously disrupted their lives, contrasted with
only one-fourth of the placebo group.

'The data shocked us'

"Their symptoms are under control, so they can have a normal life," says
Dr. Suck Won Kim, a psychiatrist at the University of Minnesota Medical
School in Minneapolis and co-author of the study. "The data shocked us. We
got fantastic results."

Researchers studying gambling behavior at Rhode Island Hospital in
Providence reported similar findings with another drug, Celexa, or
citalopram, a type of antidepressant known as an SSRI. The study was,
however, relatively small, involving just 15 compulsive gamblers, and
lasted for just 12 weeks. (The study was funded by Forest Laboratories,
which markets Celexa.)

Previous studies have suggested that people with obsessive-compulsive
behavior disorders, such as pathological gambling, suffer from a deficiency
of serotonin, a brain chemical that may be involved in the ability to delay
or prevent acting on impulses.

The class of drugs known as SSRIs (or serotonin reuptake inhibitors)
prevent serotonin from being removed from the synapses in the brain.

In the Rhode Island research, 13 of the 15 study participants reported
significant improvements in all gambling measures, including the number of
days gambled and their preoccupation with gambling.

The amount of money participants lost dropped from an average of $1,900 in
the two weeks before the study to $145 in the final two weeks.

"Individuals who are struggling to get a handle on this devastating problem
should be aware of the possible treatment options," said Dr. Mark
Zimmerman, director of outpatient psychiatry at Rhode Island Hospital and
the study's lead author.

The Food and Drug Administration has not yet approved these medications for
use in curbing gambling urges. Still, these studies suggest that
medications that compensate for deficits in brain chemistry may hold the
key to controlling impulses.