Amantadine, a substance used for treating influenza and Parkinson, could be a new treatment option for pathological gambling according to researchers from Gabriele d’Annunzio University in Chieti, Italy, reporting at the 23rd Meeting of the European Neurological Society (ENS) in Barcelona. About 3,000 experts are gathering to discuss current developments in their field. The initial results seem quite promising although larger studies will be needed for confirmation. Amantadine is a non-specific glutamate blocker.
According to pertinent studies, pathological gambling affects 0.2 to 5.3% of the adult population worldwide. This behavioural disorder is especially prevalent in people taking part in games of chance and in betting. Those affected are often unable to resist the urge to gamble. Many more men are affected by this illness than women. It usually has detrimental consequences for the patients’ personal lives, family or career.
Dr Giovanni Martinotti reported that treating gambling addicts medically has been quite difficult up until now. “There is a smattering of drugs but thus far, none of them have proven suitable as a standard therapy, e.g. been approved by the US Food and Drug Administration, the institution that sets the tone in the industry worldwide. It now looks like we might have found a drug for the first time that really has the potential to treat gambling addiction. However, we are still in the trial phase and need more data to confirm our findings.”
Affecting the dopamine balance
Amantadine is a drug for treating and preventing the influenza virus A and recently also began being used for treating Parkinson’s disease. It affects the balance of the “happiness hormone” dopamine in the brain, increasing its release while blocking its reuptake. Amantadine also affects the region of the brain known as the “nucleus accumbens”. As the gearshift lever for the “reward system” in the brain, this region plays a key part in addictions coming about. Dr Martinotti: “We were able to show that amantadine also has an effect on impulse control.”
In a case series conducted by the Italian scientists it turned out that amantadine reduced by anywhere from 43 to 64% the urge to gamble in the six pathological gamblers tested as well as thoughts about gambling, time and emotions devoted to gambling and also the personal problems associated with gambling. The test participants were evaluated using the Gambling Symptom Assessment Scale (G-SAS) with which gambling addicts can assess themselves.
In addition, the side-effects were negligible, meaning that the subjects in the study tolerated the drug well. Following this initial success, Dr Martinotti thinks it is possible that amantadine will prove itself effective in treating pathological gambling but perhaps also in treating similar impulse control disorders such as shopping addiction or online addiction. “What we need are studies with a larger number of subjects. For later approval, we also have to clarify how the drug affects possible comorbidities,” Dr Martinotti added.
23rd Meeting of the European Society of Neurology (ENS) 2013.
ENS Abstract P911: Amantadine in the treatment of pathological gambling: a case series
European Neurological Society