This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Pathological Gambling (PG) has become a significant public health problem which, until recently, has received little attention from researchers, the government, or the general public. The situation is now changing as it has become clear that the prevalence of PG is increasing, particularly as legalized gambling has proliferated. Some form of legalized gambling now exists in every state except Hawaii and Utah; in 1996 nearly $600 billion was wagered in all forms of legal gambling in the United States. PG is estimated to cost society about $5 billion per year and an additional $40 billion in lifetime costs for reduced productivity, social services, and creditor losses. The growth of the gambling industry and the increasing frequency of PG has led to an awareness of its adverse effects on individuals and society including criminal behavior, depression, substance abuse, domestic abuse and suicide. yet, despite extensive gambling related problems, little attention has been directed at developing mental health services geared at the needs of a person with PG. Critical questions about PG remain unanswered including its appropriate clinical management and response to pharmacological agents.We propose to treat persons with DSM-IV pathological gambling with escitalopram. Escitalopram is one of the marketed Serotonin Reuptake Inhibitors (SRIs) and has been shown to be safe and effective in the treatment of depression, panic and OCD. Because other SRIs have shown promise in treating Pathological Gambling Disorder, we hypothesize that Escitalopram will also be effective and well tolerated.
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