Long-acting opioid antagonist nalmefenehas shown some promise in helpingpathologic gamblers overcometheir addiction. A recent study, reportedin the American Journal of Psychiatry,randomized 207 pathologicgamblers to 25, 50, or 100 mg/day ofeither nalmefene or placebo. The 16-week trial was completed by 24 of 51placebo patients and 49 of 156 nalmefenepatients. In the 25-mg nalmefenegroup, 59% were rated as "muchimproved" or "very much improved," compared with 34% of the placebogroup. Forty-eight percent of the 50-mg group and 42% of the 100-mggroup showed some response butnone that was significantly differentfrom that of the placebo group. Sideeffects were mild to moderate, occurringduring the first week of treatment,and included nausea, dizziness, andinsomnia. Two thirds of the patients didnot complete the study, possibly due tothe side effects, although in pathologicgambling clinical trials about half of thepatients discontinued their treatment.
Ms. Farley is a freelance medicalwriter based in Wakefield, RI.