CNS Drugs

, Volume 22, Issue 2, pp 123–138 | Cite as

Pathological Gambling

An Update on Neuropathophysiology and Pharmacotherapy
  • Iulian Iancu
  • Katherine Lowengrub
  • Yael Dembinsky
  • Moshe Kotler
  • Pinhas N. Dannon
Review Article


Neurobiological research has shown the potential involvement of serotonergic, dopaminergic and opioid dysfunction in the pathophysiology of pathological gambling. In this review, we present current theories of the neuropathology of pathological gambling, paying particular attention to the role of the neural circuitry underlying motivation, reward, decision-making and impulsivity. This review also presents a literature review of current pharmacological treatment strategies for pathological gambling, such as SSRIs, opioid receptor antagonists, anti-addiction drugs and mood stabilizers, and also discusses the role of nonpharmacological interventions.

A hypothetical model of the clinical subtypes of pathological gambling is presented, e.g. the impulsive subtype, the obsessive-compulsive subtype and the addictive subtype. This model attempts to integrate current knowledge in the field of pathological gambling regarding neuropathology, psychiatric co-morbidity, family history, genetics, course of illness, gender and response to pharmacological treatment. Finally, it is proposed that the existence of possible clinical subtypes of pathological gambling may provide a potential framework for matching the various subtypes with specific pharmacotherapies.


Nucleus Accumbens Bupropion Naltrexone Pathological Gambling Gambling Behaviour 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


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Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Iulian Iancu
    • 1
    • 2
  • Katherine Lowengrub
    • 1
    • 3
  • Yael Dembinsky
    • 1
    • 2
  • Moshe Kotler
    • 1
    • 2
    • 3
  • Pinhas N. Dannon
    • 1
    • 2
    • 3
  1. 1.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.Psychiatry B. Department, Beer Yaakov Mental Health CenterTel Aviv UniversityTel AvivIsrael
  3. 3.The Rehovot Community Mental Health & Rehabilitation Clinic (affiliated to Ness Ziona - Beer Yaakov Medical Complex)RehovotIsrael

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