A Double-Blind, Placebo-Controlled Study of the Opiate Antagonist, Naltrexone, in the Treatment of Kleptomania

Jon E. Grant, JD, MD, MPH; Suck Won Kim, MD; and Brian L. Odlaug, BA
The University of Minnesota, Minneapolis

This poster presentation was supported by internal funds.

Background: Kleptomania is a rare psychiatric disorder characterized by recurrent stealing and for which there exist 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 eight-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 two 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=0.001), stealing urges (p=0.032) and stealing behavior (p<0.001) compared to subjects on placebo. Subjects assigned to naltrexone also had greater improvement in overall kleptomania severity (reflected in the CGI scores) (p<0.001). 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.

References
Blanco C, Grant J, Petry NM, et al. Prevalence and correlates of shoplifting in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Am J Psychiatry. 2008;165(7):905–913.

Grant JE, Kim SW. An open-label study of naltrexone in the treatment of kleptomania. J Clin Psychiatry. 2002;63(4):349–356.

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