Background
Kleptomania is a rare psychiatric disorder characterized by recurrent stealing and
for which there exists no empirically validated treatments. This study examined the
efficacy and tolerability of the opioid antagonist naltrexone in adults with kleptomania
who have urges to steal.
Methods
An 8-week, double-blind, placebo-controlled trial was conducted to evaluate the safety
and efficacy of oral naltrexone for kleptomania. Twenty-five individuals with DSM-IV
kleptomania were randomized to naltrexone (dosing ranging from 50 mg/day to 150 mg/day)
or placebo. Twenty-three subjects (92%) completed the study. Subjects were assessed
every 2 weeks with the Yale Brown Obsessive Compulsive Scale Modified for Kleptomania
(K-YBOCS), the urge and behavior subscales of the K-YBOCS, the Kleptomania Symptom
Assessment Scale (K-SAS), the Clinical Global Impressions Scale (CGI), and measures
of depression, anxiety, and psychosocial functioning.
Results
Subjects assigned to naltrexone had significantly greater reductions in K-YBOCS total
scores (p = .001), stealing urges (p = .032), and stealing behavior (p < .001) compared with subjects on placebo. Subjects assigned to naltrexone also had
greater improvement in overall kleptomania severity (reflected in the CGI scores)
(p < .001). The mean effective dose of naltrexone was 116.7 (±44.4) mg/day.
Conclusions
Naltrexone demonstrated statistically significant reductions in stealing urges and
behavior in kleptomania. Naltrexone was well tolerated.
Key Words
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Article info
Publication history
Published online: February 13, 2009
Accepted:
November 20,
2008
Received in revised form:
November 20,
2008
Received:
September 8,
2008
Identification
Copyright
© 2009 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
