By study endpoint, 66.7% of the naltrexone group compared to 7.7% of the placebo group (p<0.001) demonstrated symptom remission. In the only placebo-controlled, double-blind study of kleptomania, 25 subjects were randomized in a 1:1 fashion to either naltrexone or placebo for 8 weeks (Grant et al. The study showed that 41% of the subjects reported complete abstinence from stealing and 76% of the subjects reported significant reductions in their urges to steal. Seventeen subjects were followed over a 3-year period while being treated with nal-trexone (mean dose of 135.3 mg/day). A naturalistic study of naltrexone produced similar results. A mean dose of 145 mg/d resulted in a significant decline in the intensity of urges to steal, stealing thoughts, and stealing behavior in nine of the ten subjects compared to baseline symptoms. Ten subjects with kleptomania were treated over 12 weeks with escalating doses of naltrexone (50 to 200 mg/day) in an open-label design. The first (open-label) study for kleptomania involved the use of the (opioid antagonist) naltrexone. As a result, ► opioid antagonist, such as ► naltrexone, which are thought to decrease dopamine neurotransmission in the ► nucleus accumbens and the corresponding linked motivational neurocircuitry, have been proposed as beneficial agents in dampening the excitement and cravings often reported in kleptomania. Alterations in dopaminergic pathways may produce the feelings of pleasure often associated with kleptomania. Since subjects with ICDs, such as kleptomania often report uncontrollable cravings and excitement upon stealing an item, the hypothesis of a reward-triggered release of dopamine has been implicated as underlying these symptoms. Although there are no medications approved to treat kleptomania, pharmaco-therapy has shown some early promise in treating this disorder. Most of the available data are confined to one (► double-blind) study, two (► open label) studies, and case reports. There is a very limited amount of data regarding treatment for kleptomania. High rates of co-occurring psychiatric disorders (e.g., depression, anxiety, and other impulse control disorders) are common in individuals with kleptomania (McElroy et al. The majority of individuals with kleptomania have been apprehended at some time due to their stealing behavior. The inability to stop this behavior often leads to feelings of shame and guilt. Most individuals with kleptomania try unsuccessfully to stop stealing. Less than half of the married kleptomaniacs disclose their behavior to their spouses. Individuals with kleptomania frequently hoard, discard, or return stolen items. Women appear twice as likely to suffer from kleptomania as men. The course of the illness is generally chronic, with waxing and waning of symptoms. The onset of this disorder occurs typically in early adulthood but has been reported in cases as young as four and as old as 77. Kleptomania is characterized by repetitive, uncontrollable stealing of items not needed for one's personal use, and is associated with significant morbidity and morality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |