• Is Compulsive Gambling A Disease
• National Council On Compulsive Gambling
• Antidepressants And Compulsive Gambling Disorder
• Compulsive Gambling Articles

Depression is a serious mental illness that can have a devastating impact on a sufferer’s physical well-being and overall quality of life. Therefore, it’s no wonder that so many people turn to antidepressants to help them manage the symptoms of chronic depression.

A commonly used antidepressant has the unique side effect of eliminating impulse control, with some patients having uncontrollable urges to gamble, binge eat, shop or have sex, the Food and Drug. Looking for gambling in RxISK, gives 1 case in Australia, but 4 cases of pathological gambling – more than from all the rest of the world combined, and 8 cases of impulsive behavior. In the FDA database, there are many more reports from the US and Europe with a Proportional Reporting Ratio for impulse control disorder of 11.2 and for. Some anti-depressants can bring out bi-polar disorder in some people. If you notice you're taking more risks (like gambling) or having weird mood swings, it could be a sign that you might have bi-polar disorder. Also, when you go from being rock-bottom depressed, to feeling like you're on top of the world, you almost have an invincibility feeling. That's why it's possible that some people can. Some antidepressants may reduce the gambling urge, too. Narcotic antagonists — drugs used to treat drug addictions — may help some compulsive gamblers. Self-help groups: Some find it helpful.

In recent years, however, critics of these types of drugs have spoken out about their potential drawbacks and questioned their overall effectiveness. In fact, many studies have shown that antidepressants can in some cases worsen depression and cause a range of effects like nausea, weight gain, fatigue and insomnia. In addition, there appears to be a troubling new side effect that is making medical providers hesitant to prescribe antidepressants: gambling addiction.

Gambling Addiction and Antidepressant

A quick search of the Internet reveals countless studies and anecdotal accounts that show a startling link between the use of anti-depressants and compulsive gambling. People who were only casual gamblers or who had never stepped into a casino before all too often find themselves compelled to overspend at gaming tables, at the slot machines and on online gambling websites.

Scientists believe that the link between gambling addiction and antidepressant use lies in brain chemistry. Certain antidepressants cause changes in levels of a brain chemical called dopamine, with these changes having been linked to uninhibited behaviors. Not only could this cause problem gambling, but it could also lead to other consequences such as reckless driving, unprotected sex and binge drinking.

Asa result, the U.S. Food and Drug Administration has issued a statement verifying that there is a link between antidepressants, dopamine levels and gambling addiction. Nevertheless, more research is needed in order to determine who is most at risk of developing a gambling addiction due to antidepressants, and to find out if all types of antidepressant drugs pose similar risks for the problem.

Is Compulsive Gambling A Disease

Consultation Before Prescription

In the meantime, it’s important that people who are on or considering taking antidepressants for depression and other mental health conditions talk to their doctor first about the risks of gambling addiction. Doctors may subsequently recommend other treatments for those individuals who have a history of addictive behavior, or are already struggling with gambling addiction. Furthermore, people with a family history of addiction or problem gambling may also be advised to explore other treatments.

It is also important to realize that for those people taking antidepressants, and experiencing symptoms of gambling addiction, help is available. Most US states and countries that have legalized gambling, for example, offer toll-free numbers for addicts to call and receive assistance. It’s also possible to place a self-imposed gambling ban in many US states and countries, with one type of ban available enabling a person suffering from a gambling addiction to be denied access to online gambling sites permanently, or alternatively for a set period of time.

Depression Statistics

In 2016, the UK’s National Health Service prescribed a record number of antidepressants to its patients, while the World Health Organization has said that the previous year over 322 million people suffered from depression, representing around 4.4 percent of the worldwide population. Even more concerning is the fact that the past decade has seen the number soar by 18.4 percent across both the developed and developing world.

The worrying trend seems to fly in the face of a more connected digital world in which people are able to gain quicker access to goods and services leading to a pathway towards greater happiness.Tackling the important subject, Robert Lustig, a paediatric endocrinologist, has written a book recently called The Hacking of the American Mind, and as an article on the subject that appeared in the Financial Times explains:

“Part of the issue, according to Dr Lustig, is that in the modern age we have come to conflate pleasure with happiness. Pleasure, he notes, is all about the phenomenon of reward. This can be achieved by way of everything from impulsive shopping sprees to outright substance abuse. Happiness, on the other hand, is a state of general contentment that requires little in the way of a trigger.”

Addressing that point, while antidepressants do seem to help some people, those concerned about gambling addiction must carefully weigh the risks and benefits for themselves under the guidance of their doctors as science works to learn more about the link between the drugs and problem gambling.

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Compulsive gambling is being unable to resist impulses to gamble. This can lead to severe money problems, job loss, crime or fraud, and damage to family relationships.

Compulsive gambling most often begins in early adolescence in men, and between ages 20 and 40 in women.

People with compulsive gambling have a hard time resisting or controlling the impulse to gamble. The brain is reacting to this impulse in the same manner it reacts to a person addicted to alcohol or drugs. Although it shares features of obsessive compulsive disorder, compulsive gambling is likely a different condition.

In people who develop compulsive gambling, occasional gambling leads to a gambling habit. Stressful situations can worsen gambling problems.

People with compulsive gambling often feel ashamed and try to avoid letting other people know about their problem. The American Psychiatric Association defines pathological gambling as having 5 or more of the following symptoms:

• Committing crimes to get money to gamble.
• Feeling restless or irritable when trying to cut back or quit gambling.
• Gambling to escape problems or feelings of sadness or anxiety.
• Gambling larger amounts of money to try to make back past losses.
• Losing a job, relationship, education, or career opportunity due to gambling.
• Lying about the amount of time or money spent gambling.
• Making many unsuccessful attempts to cut back or quit gambling.
• Needing to borrow money due to gambling losses.
• Needing to gamble larger amounts of money in order to feel excitement.
• Spending a lot of time thinking about gambling, such as remembering past experiences or ways to get more money with which to gamble.

A psychiatric evaluation and history can be used to diagnose pathological gambling. Screening tools such as the Gamblers Anonymous 20 Questions www.gamblersanonymous.org/ga/content/20-questions can help with the diagnosis.

Treatment for people with compulsive gambling begins with recognizing the problem. Compulsive gamblers often deny they have a problem or need treatment.

Most people with pathological gambling only get treated when other people pressure them.

Treatment options include:

• Cognitive behavioral therapy (CBT).
• Self-help support groups, such as Gamblers Anonymous. Gamblers Anonymous www.gamblersanonymous.org/ is a 12-step program similar to Alcoholics Anonymous. Practices used to treat other types of addiction, such as substance use and alcohol use, can also be helpful in treating pathological gambling.
• A few studies have been done on medicines for treating compulsive gambling. Early results suggest that antidepressants and opioid antagonists (naltrexone) may help treat the symptoms of pathological gambling. However, it is not yet clear which people will respond to medicines.

Like alcohol or drug addiction, pathological gambling is a long-term disorder that tends to get worse without treatment. Even with treatment, it's common to start gambling again (relapse). However, people with pathological gambling can do very well with the right treatment.

Complications may include:

• Alcohol and drug use problems
• Anxiety
• Depression
• Financial, social, and legal problems (including bankruptcy, divorce, job loss, time in prison)
• Heart attacks (from the stress and excitement of gambling)
• Suicide attempts

Getting the right treatment can help prevent many of these problems.

Call your health care provider or mental health professional if you believe you have symptoms of pathological gambling.

Exposure to gambling may increase the risk of developing pathological gambling. Limiting exposure may be helpful for people who are at risk. Intervention at the earliest signs of pathological gambling may prevent the disorder from getting worse.

National Council On Compulsive Gambling

Gambling - compulsive; Pathological gambling; Addictive gambling

American Psychiatric Association website. Non-substance-related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:585-589.

Antidepressants And Compulsive Gambling Disorder

Compulsive Gambling Articles

Balodis IM, Potenza MN. The biology and treatment of gambling disorder. In: Johnson BA, ed. Addiction Medicine: Science and Practice. 2nd ed. Philadelphia, PA: Elsevier; 2020:chap 33.

Weissman AR, Gould CM, Sanders KM. Impulse-control disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 23.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.