Naltrexone: New Drug - New Hope For Kleptomaniacs

By Margarita Nahapetyan

It turns out that a drug that is commonly used to treat alcoholics and drug addicts, can have the same benefits when treating kleptomaniacs from their urge to steal, reports a new study by the University of Minnesota.

Kleptomania is a type of impulse control disorder that is characterized by persistent and recurrent patterns of stealing. Kleptomaniacs are not necessarily stealing for the need of food or to support a drug habit, but rather because the urge to take things - even items they don't really need - is simply irresistible. Very often kleptomaniacs realize that they should not shoplift and describe feeling ashamed for their behavior, but the pleasure that addicts experience is too "enticing" and they are unable to stop themselves.

For the small, but rigorous study, the scientists from the University of Minnesota School of Medicine, recruited 25 individuals with shoplifting habits, men and women with the ages between 17 and 75. All the participants spent an average of nearly 48 minutes per week stealing items, as well as almost 115 minutes struggling with the urge to steal. They all were randomly assigned to 2 groups - some received a placebo, while others were given drug Naltrexone, at doses ranging from 50 to 150 milligrams a day. Naltrexone is a drug, which is used to treat alcohol and drug addicts. The drug blocks the effects of endogenous opiates that may be released during stealing. In other words, it blocks the part of the brain that feels pleasure with certain addictive behaviors.

During the experiment, which lasted for 2 months, the participants were assessed every two weeks by means of the Yale Brown Obsessive Compulsive Scale Modified for Kleptomania, the urge and behavior subscales of the Yale instrument, the Kleptomania Symptom Assessment Scale, the Clinical Global Impressions Scale, as well as measures of depression, anxiety, and psychosocial functioning. The results revealed that after eight weeks of treatment, compared with those individuals who were assigned to take placebo, patients who took Naltrexone had:

• Significantly greater decline in total scores on the Yale kleptomania scale.

• Significant decline in the desire to shoplift, and actual stealing behavior.

• Greater improvement in overall kleptomania severity, as reflected in Clinical Global Impressions scores, which was significant.

The mean effective dose of Naltrexone was 116.7 milligrams a day, and that is why its side effects were generally mild and well tolerated, said Jon Grant, M.D., J.D., M.P.H., a University of Minnesota associate professor of psychiatry and the lead author of the study. Out of twenty five, 23 patients finished the study.

Limitations of the research included its relatively small size and its reliance on self-reported behavior. Also, the experts noted that "kleptomania appears to be a chronic disease that may require long-term therapy." This research did not investigate deeper on the treatment effects beyond the acute 2-month treatment period, and, therefore, further work on this matter is needed in order to determine longer-term effects of the drug. Naltrexone alone is not a cure for kleptomania, Dr. Grant said, but it offers hope to the individuals with the addiction. The scientist added that the drug would most likely work best in combination with individual therapy.

The scientists reported their findings in the latest issue of the journal Biological Psychiatry. The research was funded by a Career Development Award from the National Institute of Mental Health and the University of Minnesota Academic Health Center.