期刊
BIOLOGICAL PSYCHIATRY
卷 62, 期 6, 页码 652-657出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2006.11.021
关键词
addiction; amino acid; gambling; glutamate; pharmacology; treatment
资金
- NIMH NIH HHS [K23 MH 069754-01A1] Funding Source: Medline
Background: Although pathological gambling (PG) is relatively common, pharmacotherapy research for PG is limited. N-acetyl cysteine (NAC), an amino acid, seems to restore extracellular glutamate concentration in the nucleus accumbens and therefore offers promise in reducing addictive behavior. Methods: Twenty-seven subjects (112 women) with DSM-lV PG were treated in an 8-week open-label trial of NAC with responders (defined as a >= 30% reduction in Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling [PG-YBOCS] total score at end point) randomized to 6 weeks of double-blind NAC or placebo. Results: The PG-YBOCS scores decreased from a mean of 20.3 +/- 4.1 at baseline to 11.8 +/- 9.8 at the end of the open-label phase (P < .001). Sixteen of 27 subjects (59.3%) met responder criteria. The mean effective close of NAC was 1476.9 +/- 311.3 mg/day. Of 16 responders, 13 entered the double-blind phase. Of those assigned to NAC, 83.3% still met responder criteria at the end of the double-blind phase, compared with only 28.6% of those assigned to placebo. Conclusions: The efficacy of NAC lends support to the hypothesis that pharmacological manipulation of the glutamate system might target core symptoms of reward-seeking addictive behaviors such as gambling. Larger, longer, placebo-controlled double-blind studies are warranted.
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