Pathological Gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors (SSRIs), antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range pf pharmacologic treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment.

The 43 full -responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free, follow-up phase. Raters were blind to the previous drug treatment.

The majority of patients did not relapse during the 6-month medication- free follow-up phase. Three out of six patients with fluvoxamine, three out of nine with topiramate, seven out of eighteen with bupropion SR, and four out of ten with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication- free follow- up period. Most of the patients did not gamble during the follow- up period, and the patients that did gamble reported a decrease in gambling losses.

This naturalistic, long-term follow-up outcome study demonstrates that among pathological gamblers who respond to a six- month trial of medication, the majority of patients appear to maintain full-response during a six-month medication- free follow-up phase.