According to research studies, which medication is most likely to reduce cravings and gambling behavior in those with problem gambling?

• A. Buspar
• B. Naltrexone
• C. Wellbutrin
• D. Prozac

Answer: (B)

Understanding how medications can curb problem gambling focuses on the brain’s reward system. Naltrexone is an opioid receptor antagonist, which means it blocks the body’s natural opioid signals that reinforce rewarding experiences. When someone with problem gambling engages in gambling, these signals help drive urge and repeating the behavior. By dampening that reinforcement, naltrexone reduces both the craving to gamble and the actual gambling behavior. This effect has been shown consistently across multiple controlled studies, making it the medication with the strongest evidence for helping with both cravings and gambling acts.

Buspirone, while useful for anxiety, has limited and inconsistent evidence for reducing gambling. Bupropion and fluoxetine target mood or impulsivity in different ways but have not demonstrated reliable, robust benefits for diminishing gambling cravings or behavior in most trials. They may be used for coexisting conditions like depression, but they aren’t the primary pharmacologic choice for gambling disorder.