Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review

Marco Di Nicola, Franco De Crescenzo, Gian Loreto D'Alò, Chiara Remondi, Isabella Panaccione, Lorenzo Moccia, Marzia Molinaro, Luigi Dattoli, Alessandro Lauriola, Silvia Martinelli, Giulia Giuseppin, Francesco Maisto, Maria Luigia Crosta, Salvatore Di Pietro, Laura Amato, Luigi Janiri

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BACKGROUND AND OBJECTIVES: Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care. METHODS: MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six studies were eventually included in this meta-review. RESULTS: Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in subjects with comorbid bipolar disorders. Cognitive behavioral therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self-help interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS: We found moderate evidence of effect for CBT, but weaker evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the short but not in the long term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, to deliver patient-tailored treatments.
Original languageEnglish
Pages (from-to)e15-e23
JournalJournal of Addiction Medicine
Publication statusPublished - 2020


  • cognitive-behavioral therapy
  • gambling
  • meta-review
  • personalized medicine
  • pharmacological treatment
  • psychotherapy


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