Dannon Pinhas N
Tel Aviv University, Israel
Pinhas Dannon MD, is a psychiatrist and an associated professor in psychiatry with the Sackler Faculty of Medicine at Tel Aviv University. He is the director of Day Care Rehabilitation Center and the Research Department at Beer Yaakov Mental Health Center. A graduate of the School of Medicine of Istanbul University, he completed training at Wolfson Medical Center and specialized training at Sheba Medical Center-Tel Has homer. Prof. Dannon served as the head of anxiety & depression outpatient clinics at Sheba Medical Center and the head of Rehovot's Community Mental Health and Rehabilitation Clinic. Dr Dannon is internationally recognized for his research and publications in the treatment of depression, panic disorder and behavioral addictions, including kleptomania, internet addiction, shopping addiction and pathological gambling. He is currently published his book "We are all addicted" in the field of addictions.
Background: Pathological Gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents includes SSRIs, antiepileptic drugs, and opioid antagonists. All are shown to be effective in the short-term treatment of PG. The aim of the study is to assess the relapse rates in treatment-responder pathological gamblers after discontinuation of the treatment. Methods: Our study sample was composed of 63 pathological gamblers who had been full responders to one of four treatment regimens (fluvoxamine, topiramate, bupropion or naltrexone) from previous studies. The 63 full -responders were then followed prospectively for an additional 18 months, which included a 3-month open-label continuation phase and a 12-month medication-free, follow-up phase. Follow-up visits were performed on a monthly basis. At every follow-up visit, a comprehensive psychiatric diagnostic evaluation was performed on all patients. Raters were blind to the previous drug treatment. Results: The majority of patients did not relapse during the 12-month medication- free follow-up phase. Relapse was strictly defined as gambling behavior at any time during the 12-month medication- free follow- up period. Naltrexone treated gamblers had least gambling experience and topiramate treated gamblers had the most. Majority of the patients did not gamble during the follow- up period, and the patients that did gamble reported a decrease in gambling losses. Conclusion: This naturalistic, long-term follow-up outcome study demonstrates that among pathological gamblers who respond to a 24- month trial of medication, the majority of patients appear to maintain full-response during a 12-month medication- free follow-up phase.