Effectiveness of Sertraline in Treating Pathological Gamblers With a Diagnosis of Alcohol Dependence - 1

Alcohol abuse and depression commonly occur in conjunction with pathological gambling.
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) currently used to
treat depression, panic disorder, and obsessive-compulsive disorder. The purpose of this
trial is to determine the effectiveness of sertraline combined with relapse prevention
therapy in decreasing gambling behavior and alcohol abuse.

Participants in this 10-week trial will be randomly assigned to receive either relapse
prevention (RP) therapy and sertraline or RP therapy and a placebo. Participants will begin
taking 25 mg of either sertraline or placebo in a single morning dose for one week. If,
after one week, participants do not show improvement, the dose will increase to 50 mg per
day during Week 2, and will increase by 50 mg per day every week thereafter to a maximal
dose of 200 mg per day.

Weekly hour-long study visits will include a medication evaluation, RP therapy, and
questionnaires. In addition, evaluations at baseline, Week 5, and Week 10 will include
pathological gambling and depression ratings, urine drug screens, and biochemical measures
of alcohol consumption and liver function. All other weekly study visits will include
evaluation of side effects, an interview on alcohol use, measures related to
obsessive-compulsive drinking, and assessments of vital signs and concomitant medications.