Contents

Search

pathologic gambling; compulsive gambling

Etiology: - associated with alcoholism & tobaccoism [2] - high incidence of depression, bipolar disorder, psychosis, anxiety disorder, personality disorder, substance abuse (including alcohol & tobacco), ADHD - behavioral disturbances & personality changes of early dementia [1] - boredom: - older adults are more likely than younger adults to cite relief from boredom as a reason for gambling [2] Epidemiology: - 1-2% of population with pathologic gambling - older persons less likely to gamble than younger persons Management: 1) screen for alcohol abuse, tobacco use & other substance abuse disorders 2) no medication helpful in reducing pathologic gambling - pharmacotherapy most effective when targeting comorbid condition [2] 3) selective serotonin reuptake inhibitor (SSRI) 4) concurrent bipolar disorder a) divalproex b) lithium carbonate 5) naltrexone (ReVia) has not been shown to decrease the urge to gamble [2]

General

impulse control disorder

References

  1. Prescriber's Letter 9(9):53 2002
  2. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  3. Pilver CE, Libby DJ, Hoff RA, Potenza MN. Problem gambling severity and the incidence of Axis I psychopathology among older adults in the general population. J Psychiatr Res. 2013 Apr;47(4):534-41. Epub 2013 Jan 16. PMID: 23333039 Free PMC Article
  4. Tse S, Hong SI, Wang CW, Cunningham-Williams RM. Gambling behavior and problems among older adults: a systematic review of empirical studies. J Gerontol B Psychol Sci Soc Sci. 2012 Sep;67(5):639-52. Review. PMID: 22929398