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Pill that may help gambling addicts



Bad brain wiring.

When something gets skewed in the brain's pleasure pathways, an ordinary person can turn into a compulsive drinker, drug-user or gambler.

The patterns in all three appear to be the same, and the cure might be as simple as a pill and some therapy, said Sandra Lapham, a doctor at the Behavioral Health Research Center of the Southwest in Albuquerque.

"The brain works in such a way that we get in these ruts in our neuro-chemical pathways, and that makes us fall into patterns of behavior," Lapham said. "For some people, if you take away that underlying craving, change that pathway, then you take away the enjoyment of that behavior and can stop it."

Lapham this month is starting a clinical trial to treat compulsive gambling with a pill that blocks the brain's pleasure pathways and keeps the person from enjoying a gambling high. The name of the pill is confidential as part of the study, she said.

The pill has worked successfully treating alcoholics but has never been tried on compulsive gamblers before, she added.

"Gambling is definitely an addiction, it tends to have a genetic predisposition," Lapham said. "It also has very similar symptoms to many drug and alcohol addictions. Up until now, there haven't been any medications for gambling addictions. It's all been psycho-social therapies. This is an exciting time to be in the addiction field."

If a pill to stop gambling seems odd, consider this: A drug called Martex, used to treat Parkinson's disease, has actually created compulsive gambling problems in patients that never had them before, said Kandace Blanchard, executive director of the New Mexico branch of the National Council on Problem Gambling.

"It's strange, but when they take people off the drug, they stop gambling," she said. "If they get to the bottom of that, they'd really be getting to the bottom of a lot of addiction problems."

The symptom list for gambling addiction is similar to that of those for alcohol and drugs.

Compulsive gamblers typically have five or more of these 10 symptoms:

Preoccupation with gambling; escalated need for gambling at higher stakes; repeated unsuccessful attempts to quit or cut down; restlessness and cravings when avoiding gambling; betting more to make up for losses rather than stopping; lying about gambling; doing illegal acts to get money for gambling; strained jobs and relationships; relying on others to solve problems.

"Your decision to do the behavior when you first start it is totally voluntary - much like it is with alcohol or drugs," she said. "But at some point, it sets up something in the brain that changes the behavior from voluntary to compulsive. It takes over your thinking."

Treatment with the pill is typically given to addicts for three months. Lapham wants to try it for six months, because she thinks it will be more successful.

"A lot of people are able to stop after that amount of time and change their behavior and the pathways behind it," Lapham said.

The medication also blocks pleasure from normal activities, however, so the goal is to take patients off it as quickly as possible.

"If you're using a substance or gambling for an artificial high, the pleasure receptor sites in your brain down-regulate," Lapham said. "They become less sensitive to naturally occurring highs from things like exercise, eating and sex. So you're down-regulating a person who already is down-regulated."

Because addicts already have problems experiencing pleasure naturally, sometimes they are treated with anti-depressants after the initial treatment is over, she added.

Finding subjects for the study might be difficult because compulsive gambling is often found together with other addiction problems. Those with just compulsive gambling problems are often easier to treat, however, Blanchard said.

"There's a huge problem with co-morbidity where you have alcoholism and gambling problems, or a mood disorder and a gambling problem. Normally, you don't see it on its own," Blanchard said.

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