Possible effect of blonanserin on gambling disorder: A clinical study protocol and a case report

Abstract

Background: Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences. Although several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder, new treatment strategies are needed. Growing evidence suggests that dopamine D3 receptor plays a specific role in the brain reward system.

Aim: To investigate if blonanserin, a dopamine D3 receptor antagonist, would be effective in reducing gambling impulses in patients with gambling disorder.

Methods: We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder, in which up to 12 mg/d of blonanserin was prescribed for 8 wk.

Results: A 37-year-old female patient with gambling disorder, intellectual disability, and other physical diseases participated in the pilot study. The case showed improvement of gambling symptoms without any psychotherapy. However, blonanserin was discontinued owing to excessive saliva production.

Conclusion: This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies, but it also carries a risk of adverse effects. Further studies are needed to confirm the findings.

Keywords: Blonanserin; Case report; Clinical trial protocol; D3 receptor; Gambling disorder; Medication.

Figure 1

Clinical course of the participant. Each number on graph represents the total score of rating scale at each time of evaluation. GSAS: Gambling Symptom Assessment Scale, total score; PG-YBOCS: the Yale–Brown Obsessive Compulsive Scale: Pathological Gambling Modification, total score; BIS11: the Barratt Impulsiveness Scale, total score; DIEPSS: Drug Induced Extra-Pyramidal Symptoms Scale, overall severity score; MADRS: Montgomery-Asberg Depression Scale, total score; YMRS: Young Mania Rating Scale, total score.