One of the most common questions people ask about gambling disorder treatment is whether there is a medication that can help. The honest answer is nuanced: no medication is currently FDA-approved specifically for gambling disorder, but several medications have shown meaningful evidence of benefit in clinical trials.
Medication is not a cure, and it is most effective when combined with therapy and support. But for many people, pharmacological treatment can reduce the intensity of urges and make the psychological work of recovery more manageable.
Naltrexone: The Strongest Evidence
Naltrexone is an opioid receptor antagonist — it blocks the opioid receptors that are involved in the reward response to gambling. Multiple randomized controlled trials have found that naltrexone significantly reduces gambling urges, gambling frequency, and gambling-related harm in people with gambling disorder.
A 2014 meta-analysis of 14 studies found that naltrexone produced a significant reduction in gambling behavior compared to placebo, with a moderate effect size. The medication is particularly effective for people with strong gambling urges and a family history of alcohol use disorder (which suggests a strong opioid-reward pathway).
Dosing: Typically 50–150mg daily. Higher doses (100–150mg) may be more effective for gambling disorder than the standard 50mg dose used for alcohol use disorder.
Side effects: Nausea (most common, usually temporary), headache, fatigue. Liver function monitoring is recommended.
N-Acetyl Cysteine (NAC)
N-acetyl cysteine is an amino acid supplement that affects glutamate neurotransmission — a system involved in compulsive behaviors. A small but promising randomized controlled trial found that NAC significantly reduced gambling urges compared to placebo in people with gambling disorder.
NAC is available over-the-counter as a supplement, though it should be used under medical supervision for gambling disorder treatment.
Antidepressants
The evidence for antidepressants in gambling disorder is mixed. SSRIs (selective serotonin reuptake inhibitors) have shown inconsistent results in clinical trials — some studies show benefit, others show no difference from placebo. However, for people with gambling disorder and co-occurring depression or anxiety, treating the co-occurring condition with an antidepressant may indirectly reduce gambling behavior.
Mood Stabilizers
For people with gambling disorder and co-occurring bipolar disorder, mood stabilizers (lithium, valproate) may reduce gambling behavior by stabilizing the manic episodes that often drive gambling escalation.
Important Caveats
- All medications for gambling disorder should be prescribed and monitored by a physician familiar with the condition
- Medication works best as part of a comprehensive treatment plan that includes therapy
- No medication eliminates gambling urges entirely — they reduce intensity and frequency
- The decision to use medication should be made collaboratively with a healthcare provider
The National Problem Gambling Helpline (1-800-522-4700) can help connect you with treatment providers who have experience with pharmacological treatment for gambling disorder.
