Journal of Gambling Studies

, Volume 30, Issue 2, pp 467–473

Citalopram-Associated Gambling: A Case Report

  • Ilaria Cuomo
  • Georgios D. Kotzalidis
  • Federica Caccia
  • Emanuela Danese
  • Giovanni Manfredi
  • Paolo Girardi
Original Paper

DOI: 10.1007/s10899-013-9360-2

Cite this article as:
Cuomo, I., Kotzalidis, G.D., Caccia, F. et al. J Gambl Stud (2014) 30: 467. doi:10.1007/s10899-013-9360-2

Abstract

Pathological gambling behaviour is a side effect of dopaminergic drugs used in Parkinson’s disease, but has seldom been reported with selective serotonin reuptake inhibitors. A 58-years-old woman with somatisation disorder since the age of 20 and recent-onset major depression (at 54 years) received 40 mg/day intravenous citalopram, thereafter switching to the same dose of oral citalopram to treat her comorbid psychiatric disorders after showing poor response to paroxetine for one year. Her anxious and depressive symptoms were moderately reduced after 7 months of oral citalopram, but simultaneously, the patient admitted gambling. We gradually discontinued citalopram and introduced pregabalin and alprazolam; this was followed by a reduction of gambling compulsions, but the somatisation and depressive symptoms did not further improve. Pathological gambling may be mediated by an interplay of 5-HT1A serotonergic and D2 dopaminergic mechanisms. Citalopram affects both these mechanisms in areas that were shown to be involved in gambling behaviour, but while dopaminergic effects of citalopram appear to be consistent with the induction of gambling, its serotonergic mechanisms are rather inconsistent. In our patient, mood destabilisation induced by citalopram may have contributed to the first onset of pathological gambling.

Keywords

Selective serotonin reuptake inhibitors Citalopram Pathological gambling Major depressive disorder Somatisation disorder 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ilaria Cuomo
    • 1
  • Georgios D. Kotzalidis
    • 1
  • Federica Caccia
    • 1
  • Emanuela Danese
    • 1
  • Giovanni Manfredi
    • 1
  • Paolo Girardi
    • 1
  1. 1.NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Unit of Psychiatry, School of Medicine and Psychology, Sant’Andrea HospitalSapienza UniversityRomeItaly

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