Disulfiram, an option for the treatment of pathological gambling?

AIM Pathological gambling and comorbid alcohol dependence often occur in combination. Disulfiram is one of the proven drugs for alcohol dependence. In addition to its inhibiting acetaldehyde dehydrogenase, disulfiram inhibits dopamine beta-hydroxylase and may thereby increase dopamine and decrease norepinephrine cerebral concentrations. Because there may be common neurochemical substrates and neuronal circuits for pathological gambling and addiction, we wished to explore the effect of disulfiram in gambling. METHOD We describe the outcome of a patient with alcohol dependence and pathological gambling treated with disulfiram D. RESULTS During treatment with disulfiram, the patient reported that his desire to gamble disappeared entirely. Follow-up indicated that he has not gambled for >12 months. CONCLUSIONS Although uncontrolled case observations should be interpreted with caution, disulfiram deserves further investigation in pathological gambling.