Cochrane · systematic review · CD008936
Pharmacological interventions for the treatment of disordered and problem gambling
Dowling, N, Merkouris, S, Lubman, D, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
56
current version
GRADE rated
38
No studies
18
Included studies
NR
No studies 18 · 32.1%Ungraded 0 · 0%Very low 29 · 51.8%Low 9 · 16.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antidepressants compared to placebo for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Antidepressants vs placebo | no estimate extracted | 5 studies · 225 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Gambling expenditure Antidepressants vs placebo | no estimate extracted | 3 studies · 144 participants | Low Downgraded: risk of bias, imprecision |
Gambling frequency Antidepressants vs placebo | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Time spent gambling Antidepressants vs placebo | no estimate extracted | 1 study · 39 participants | Low Downgraded: imprecision |
Depressive symptoms Antidepressants vs placebo | no estimate extracted | 3 studies · 90 participants | Low Downgraded: risk of bias, imprecision |
Anxiety symptoms Antidepressants vs placebo | no estimate extracted | 1 study · 41 participants | Very low Downgraded: risk of bias, imprecision |
Functional impairment Antidepressants vs placebo | no estimate extracted | 2 studies · 110 participants | Low Downgraded: risk of bias, imprecision |
Responder status Antidepressants vs placebo | RR 1.24 [0.93, 1.66] | 6 studies · 268 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Opioid antagonists compared to placebo for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Opioid antagonists vs placebo | no estimate extracted | 3 studies · 259 participants | Low Downgraded: risk of bias, imprecision |
Gambling expenditure ‐ not measured Opioid antagonists vs placebo | no estimate extracted | NR | No studies |
Gambling frequency ‐ not measured Opioid antagonists vs placebo | no estimate extracted | NR | No studies |
Time spent gambling ‐ not measured Opioid antagonists vs placebo | no estimate extracted | NR | No studies |
Depressive symptoms Opioid antagonists vs placebo | no estimate extracted | 1 study · 77 participants | Low Downgraded: imprecision |
Anxiety symptoms Opioid antagonists vs placebo | no estimate extracted | 1 study · 77 participants | Low Downgraded: imprecision |
Functional impairment Opioid antagonists vs placebo | no estimate extracted | 1 study · 77 participants | Low Downgraded: imprecision |
Responder status Opioid antagonists vs placebo | RR 1.65 [0.86, 3.14] | 4 studies · 562 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Mood stabilisers compared to placebo for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Mood stabilisers vs placebo | no estimate extracted | 2 studies · 71 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Gambling expenditure Mood stabilisers vs placebo | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Gambling frequency Mood stabilisers vs placebo | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Time spent gambling Mood stabilisers vs placebo | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Depressive symptoms Mood stabilisers vs placebo | no estimate extracted | 2 studies · 71 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Anxiety symptoms Mood stabilisers vs placebo | no estimate extracted | 2 studies · 71 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional impairment Mood stabilisers vs placebo | no estimate extracted | 1 study · 42 participants | Very low Downgraded: risk of bias, imprecision |
Responder status Mood stabilisers vs placebo | RR 2.69 [1.14, 6.32] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Atypical antipsychotics compared to placebo for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Atypical antipsychotics vs placebo | no estimate extracted | 2 studies · 63 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Gambling expenditure Atypical antipsychotics vs placebo | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Gambling frequency Atypical antipsychotics vs placebo | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Time spent gambling Atypical antipsychotics vs placebo | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Depressive symptoms Atypical antipsychotics vs placebo | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anxiety symptoms Atypical antipsychotics vs placebo | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional impairment ‐ not measured Atypical antipsychotics vs placebo | no estimate extracted | NR | No studies |
Responder status Atypical antipsychotics vs placebo | RR 0.93 [0.62, 1.4] | 1 study · 42 participants | Low Downgraded: risk of bias, imprecision |
Antidepressants compared to opioid antagonists for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Antidepressants vs opioid antagonists | no estimate extracted | 1 study · 25 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Gambling expenditure ‐ not measured Antidepressants vs opioid antagonists | no estimate extracted | NR | No studies |
Gambling frequency ‐ not measured Antidepressants vs opioid antagonists | no estimate extracted | NR | No studies |
Time spent gambling ‐ not measured Antidepressants vs opioid antagonists | no estimate extracted | NR | No studies |
Depressive symptoms Antidepressants vs opioid antagonists | no estimate extracted | 2 studies · 62 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anxiety symptoms Antidepressants vs opioid antagonists | no estimate extracted | 2 studies · 62 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional impairment ‐ not measured Antidepressants vs opioid antagonists | no estimate extracted | NR | No studies |
Responder status Antidepressants vs opioid antagonists | RR 1.01 [0.54, 1.87] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Antidepressants compared to mood stabilisers for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity Antidepressants vs mood stabilisers | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Gambling expenditure ‐ not measured Antidepressants vs mood stabilisers | no estimate extracted | NR | No studies |
Gambling frequency ‐ not measured Antidepressants vs mood stabilisers | no estimate extracted | NR | No studies |
Time spent gambling ‐ not measured Antidepressants vs mood stabilisers | no estimate extracted | NR | No studies |
Depressive symptoms Antidepressants vs mood stabilisers | no estimate extracted | 2 studies · 58 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anxiety symptoms Antidepressants vs mood stabilisers | no estimate extracted | 2 studies · 58 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional impairment ‐ not measured Antidepressants vs mood stabilisers | no estimate extracted | NR | No studies |
Responder status Antidepressants vs mood stabilisers | RR 0.63 [0.29, 1.33] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Opioid antagonists compared to mood stabilisers for the treatment of disordered and problem gambling
Population: treatment of disordered and problem gambling
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gambling symptom severity ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |
Gambling expenditure ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |
Gambling frequency ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |
Time spent gambling ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |
Depressive symptoms Opioid antagonists vs mood stabilisers | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Anxiety symptoms Opioid antagonists vs mood stabilisers | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Functional impairment ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |
Responder status ‐ not measured Opioid antagonists vs mood stabilisers | no estimate extracted | NR | No studies |