Pathological Gambling
Conditions
Keywords
amphetamine, d1 and d2 receptors, dopamine antagonists, pathological gambling, priming, reinforcement
Brief summary
To determine if: 1. pathological gambling is similar to psychostimulant addiction as reflected by parallel roles for D1 and D2 receptors in gambling and stimulant reinforcement. 2. these parallel roles are linked with gambling pathology or if they are evident in both gamblers and controls.
Detailed description
BACKGROUND: No previous research appears to have investigated the role of dopamine (DA) D1 or D2 receptors in psychostimulant reinforcement in pathological gamblers. Effects of haloperidol vs. placebo will reveal the role of D2 and the effects of fluphenazine vs. haloperidol will reveal the role of D1 in this process. OBJECTIVE: This study will begin to define the neurochemistry of Pathological Gambling by examining the roles of dopamine D1 and D2 receptors in gambling reinforcement and psychostimulant reinforcement, and exploring genetic predictors of response to DA probes in Pathological Gambling subjects (subjects) and healthy controls. METHODS: A double-blind, placebo controlled, counterbalanced between-within design will be employed. Each participant will attend 4 sessions with a minimum of 1 week between sessions to ensure drug washout. Responses to the slot machine will be assessed in sessions 1 and 2 (Phase I), and responses to amphetamine will be assessed in sessions 3 and 4 (Phase II). A second capsule (dummy) will be administered at expected peak levels for each antagonist on sessions 1 and 2 to standardize the procedure across sessions. Subjective reinforcement self-report scales will be administered at key intervals throughout the study. HYPOTHESIS: It is hypothesized that haloperidol (3-mg) will increase priming (Desire to Gamble, Gambling word salience) and pleasurable effects (e.g., Enjoyment/Liking) induced by playing a slot machine in Pathological Gambling subjects (N = 40). If gambling and stimulant reinforcement are mediated by common mechanisms, haloperidol will also increase priming and pleasurable effects of amphetamine (20-mg) in Pathological Gambling subjects. If D1 mediates effects of haloperidol, the mixed D1-D2 antagonist, fluphenazine (fluphenazine; 3-mg) will decrease or not alter responses to the slot machine and amphetamine in Pathological Gambling subjects. If D2 deficits are linked with gambling pathology, haloperidol will not affect slot machine or amphetamine reinforcement in controls (N= 40). If D1 deficits are linked with gambling pathology, fluphenazine will increase gambling and amphetamine reinforcement in controls, by mitigating undue D1 activation in subjects with high baseline D1 function. If D1 or D2 genes contribute to gambling or amphetamine reinforcement, genotype will predict responses to the manipulations.
Interventions
DRUGHaloperidol
Dose/maximum dose = 3-mg; route = oral. Participants assigned to the haloperidol antagonist group will receive 2 doses (@ 3 mg) on alternate sessions (with minimum of 2 weeks between individual doses). Dose 1: 3 visually identical capsules, each containing 1 mg haloperidol.
DRUGFluphenazine
Dose/maximum dose = 3-mg; route = oral. Participants assigned to the fluphenazine antagonist group will receive 2 doses (@ 3 mg) on alternate sessions (with minimum of 2 weeks between individual doses). Dose 1: 3 visually identical capsules, each containing 1 mg fluphenazine.
DRUGDexedrine
Dose/maximum dose = 20-mg; route = oral. All participants will receive 2 doses (@ 20 mg) during Phase II - sessions 3, 4, with minimum 1 week between individual doses. Dose 2: when participants reach expected peak blood levels for dose 1, they will receive their second dose. On sessions 3 and 4 (Phase II), the dose will consist of 2 visually identical capsules each containing 10 mg D-amphetamine.
DRUGPlacebo
Dose 1: On alternate sessions (1 and 3 or 2 and 4, depending on counterbalancing) participants will receive 3 visually identical placebo (lactose) capsules. Dose 2: when participants reach expected peak blood levels for dose 1, they will receive their second dose. On sessions 1 and 2 (Phase I), this will consist of 2 dummy capsules, visually identical to those administered for dose 1.
BEHAVIORALSlot Machine
15 minute play of a commercial slot machine game in bar-simulated laboratory setting.
Sponsors
Canadian Institutes of Health Research (CIHR)
Centre for Addiction and Mental Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* PATHOLOGICAL GAMBLERS * otherwise healthy, non-treatment seeking, non-abstinent * male or female * ages 19-65 * DSM-IV PG symptom scale score \> 5 * SOGS (South Oaks Gambling Screen) score \> 5 * nicotine dependence acceptable * CONTROLS * healthy * male or female * ages 19-65 * DSM-IV PG symptom scale score = 0 * SOGS score = 0 * nicotine dependence acceptable * must have played slot machine \> 5 times
Exclusion criteria
* both Pathological Gamblers and Controls * Axis I psychopathology aside from nicotine dependence (or PG) based on SCID * Schizotypal or Borderline Personality Disorder based on psychiatric interview * Family history of schizophrenia or bipolar disorder * English comprehension below grade 7 level. * ADS (Alcohol Dependence Scale) \> 13 (more than low dependence) * BDI (Beck Depression Inventory) short form \> 10 (more than low depression) * DAST (Drug Abuse Screening Test) \> 4 (possible drug abuse) * Consumption of \> 20/15 (men/women) standard alcoholic drinks/ week (hazardous drinking) * Smoking \> 20 cigarettes/day to help minimize withdrawal symptoms during test phase * Any prior use of psychostimulant drugs * Current use of medication that could interact with any of the study medications * Women who are pregnant or breastfeeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Subjective Reinforcement Self-report Scales | At key points in testing: immediately after the slot machine game, and at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration). | Self-reported Confidence to Refrain from Gambling (0 - 10) was assessed at test session baseline, before the slot machine and after the slot machine (Phase 1); and before amphetamine and at peak amphetamine (Phase 2). The maximum score (10) denotes complete confidence to refrain from gambling (i.e., NO urge or compulsion to gamble); the minimum score (0) denotes complete lack of confidence to refrain from gambling (i.e., overwhelming urge to gamble). Scores between 10 and 0 denote intermediate confidence to refrain from gambling with LOWER scores denoting less confidence to refrain from gambling -- i.e., GREATER urge or compulsive motivation to gamble. Scores shown are based on single item visual analogue ratings 0-10 from each participant at the specified time point. The mean (SD) of these single item ratings is presented for each sub-group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diastolic Blood Pressure (DBP) | At key points in testing: immediately after the slot machine game (change from session baseline), and at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration)(change from session baseline). | Measure changes from baseline, especially physiologic reactivity to the slot machine and amphetamine. |
| Cognitive Task Performance | At key points during testing: immediately after the slot machine, at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration) | Response time to words (gambling, alcohol, positive affect, negative affect) as a percentage of neutral categorized words (parts of a building). This provides an index of the relative salience of stimuli from these four categories against a baseline of reaction to words with no clinical relevance or emotional valence. Smaller scores indicate faster relative response time to the test stimuli vs. neutral stimuli (i.e., greater salience) |
| Betting Behaviour in Laboratory-based Slot Machine Game | 1x per test session (total of 4 test sessions) for duration of the study: 4 weeks (1 session/week) | Risk taking was operationally defined as credits wagered per spin (mean computed for total spins) |
| Speed of Play on Slot Machine Game | 15-minutes | Number of individual spins in a 15-minute slot machine game. Each spin corresponds to one wager. |
| Winnings on Slot Machine Upon Completion of Game | 15-minutes | Credits |
Countries
Canada
Participant flow
Recruitment details
Recruitment was conducted for all groups between January 2010 and May 2015
Pre-assignment details
Pathological Gamblers and healthy Controls were each randomized to receive Haloperidol or Fluphenazine. In each group, treatment sequence (antagonist first, placebo second; or vice versa) was counterbalanced across participants, to control for order effects only (sequence was not a test factor). Two Haloperidol-Controls dropped out after session 1.
Participants by arm
| Arm | Count |
|---|---|
| Haloperidol - Pathological Gamblers A total of 15 pathological gamblers were enrolled in this arm. | 15 |
| Fluphenazine - Pathological Gamblers A total of 15 pathological gamblers were enrolled in this arm. | 15 |
| Haloperidol - Controls A total of 15 control subjects were enrolled in this arm. | 15 |
| Fluphenazine - Controls A total of 15 control subjects were enrolled in this arm. | 15 |
| Total | 60 |
Baseline characteristics
| Characteristic | Total | Haloperidol - Pathological Gamblers | Fluphenazine - Controls | Haloperidol - Controls | Fluphenazine - Pathological Gamblers |
|---|---|---|---|---|---|
| Age, Continuous | 36.3 years | 35.8 years | 39.9 years | 36.1 years | 33.5 years |
| Alcohol Dependence Scale | 0.9 units on a scale | 1.1 units on a scale | 0.3 units on a scale | 0.6 units on a scale | 1.6 units on a scale |
| Beck Depression Inventory - past 2 weeks | 3.02 units on a scale STANDARD_DEVIATION 2.85 | 4.3 units on a scale STANDARD_DEVIATION 3.6 | 1.3 units on a scale STANDARD_DEVIATION 2.1 | 0.9 units on a scale STANDARD_DEVIATION 1.2 | 5.6 units on a scale STANDARD_DEVIATION 4.5 |
| Eysenck Impulsivity Scale | 5.47 units on a scale STANDARD_DEVIATION 3.35 | 9.2 units on a scale STANDARD_DEVIATION 4.4 | 1.6 units on a scale STANDARD_DEVIATION 2.5 | 2.6 units on a scale STANDARD_DEVIATION 2.1 | 8.5 units on a scale STANDARD_DEVIATION 4.4 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 4 Participants | 1 Participants | 1 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 44 Participants | 11 Participants | 11 Participants | 11 Participants | 11 Participants |
| Race (NIH/OMB) White | 11 Participants | 3 Participants | 3 Participants | 2 Participants | 3 Participants |
| Sex: Female, Male Female | 21 Participants | 5 Participants | 7 Participants | 5 Participants | 4 Participants |
| Sex: Female, Male Male | 39 Participants | 10 Participants | 8 Participants | 10 Participants | 11 Participants |
| South Oaks Gambling Screen (SOGS) | 5.7 units on a scale | 11.1 units on a scale | 0 units on a scale | 0 units on a scale | 11.7 units on a scale |
| Timeline Followback | 1.7 number of alcoholic drinks per week | 2.3 number of alcoholic drinks per week | 1.8 number of alcoholic drinks per week | 1.5 number of alcoholic drinks per week | 1.5 number of alcoholic drinks per week |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 15 | 0 / 15 | 2 / 15 | 0 / 15 |
| serious Total, serious adverse events | 0 / 15 | 0 / 15 | 0 / 15 | 0 / 15 |
Outcome results
Primary
Subjective Reinforcement Self-report Scales
Self-reported Confidence to Refrain from Gambling (0 - 10) was assessed at test session baseline, before the slot machine and after the slot machine (Phase 1); and before amphetamine and at peak amphetamine (Phase 2). The maximum score (10) denotes complete confidence to refrain from gambling (i.e., NO urge or compulsion to gamble); the minimum score (0) denotes complete lack of confidence to refrain from gambling (i.e., overwhelming urge to gamble). Scores between 10 and 0 denote intermediate confidence to refrain from gambling with LOWER scores denoting less confidence to refrain from gambling -- i.e., GREATER urge or compulsive motivation to gamble. Scores shown are based on single item visual analogue ratings 0-10 from each participant at the specified time point. The mean (SD) of these single item ratings is presented for each sub-group.
Time frame: At key points in testing: immediately after the slot machine game, and at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Plac -Confidence not to gamble at peak amphetamine | 5.5 units on a scale | Standard Deviation 2.3 |
| Haloperidol - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Placebo - Confidence not to gamble after slot mach | 4.2 units on a scale | Standard Deviation 2.5 |
| Haloperidol - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble after slot machine | 4.8 units on a scale | Standard Deviation 2.3 |
| Haloperidol - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble at peak amphetamin | 5.2 units on a scale | Standard Deviation 2.5 |
| Fluphenazine - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Plac -Confidence not to gamble at peak amphetamine | 5.7 units on a scale | Standard Deviation 3.5 |
| Fluphenazine - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble at peak amphetamin | 6.4 units on a scale | Standard Deviation 3.2 |
| Fluphenazine - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble after slot machine | 4.8 units on a scale | Standard Deviation 2.9 |
| Fluphenazine - Pathological Gamblers | Subjective Reinforcement Self-report Scales | Placebo - Confidence not to gamble after slot mach | 4.8 units on a scale | Standard Deviation 3.4 |
| Haloperidol - Controls | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble after slot machine | 9.5 units on a scale | Standard Deviation 1.1 |
| Haloperidol - Controls | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble at peak amphetamin | 9.8 units on a scale | Standard Deviation 0.5 |
| Haloperidol - Controls | Subjective Reinforcement Self-report Scales | Plac -Confidence not to gamble at peak amphetamine | 9.4 units on a scale | Standard Deviation 1.1 |
| Haloperidol - Controls | Subjective Reinforcement Self-report Scales | Placebo - Confidence not to gamble after slot mach | 9 units on a scale | Standard Deviation 1.6 |
| Fluphenazine - Controls | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble after slot machine | 9.3 units on a scale | Standard Deviation 1 |
| Fluphenazine - Controls | Subjective Reinforcement Self-report Scales | Drug - Confidence not to gamble at peak amphetamin | 9.8 units on a scale | Standard Deviation 0.4 |
| Fluphenazine - Controls | Subjective Reinforcement Self-report Scales | Placebo - Confidence not to gamble after slot mach | 8.2 units on a scale | Standard Deviation 3.4 |
| Fluphenazine - Controls | Subjective Reinforcement Self-report Scales | Plac -Confidence not to gamble at peak amphetamine | 9.3 units on a scale | Standard Deviation 2.6 |
Secondary
Betting Behaviour in Laboratory-based Slot Machine Game
Risk taking was operationally defined as credits wagered per spin (mean computed for total spins)
Time frame: 1x per test session (total of 4 test sessions) for duration of the study: 4 weeks (1 session/week)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under drug | 12.8 credits/spin on slot machine | Standard Deviation 7.2 |
| Haloperidol - Pathological Gamblers | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under placebo | 10.4 credits/spin on slot machine | Standard Deviation 9.3 |
| Fluphenazine - Pathological Gamblers | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under placebo | 16.1 credits/spin on slot machine | Standard Deviation 12.4 |
| Fluphenazine - Pathological Gamblers | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under drug | 16.0 credits/spin on slot machine | Standard Deviation 10.4 |
| Haloperidol - Controls | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under drug | 11.6 credits/spin on slot machine | Standard Deviation 7.8 |
| Haloperidol - Controls | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under placebo | 9.5 credits/spin on slot machine | Standard Deviation 10.8 |
| Fluphenazine - Controls | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under drug | 14.4 credits/spin on slot machine | Standard Deviation 10 |
| Fluphenazine - Controls | Betting Behaviour in Laboratory-based Slot Machine Game | Mean bet under placebo | 12.2 credits/spin on slot machine | Standard Deviation 9.5 |
Secondary
Cognitive Task Performance
Response time to words (gambling, alcohol, positive affect, negative affect) as a percentage of neutral categorized words (parts of a building). This provides an index of the relative salience of stimuli from these four categories against a baseline of reaction to words with no clinical relevance or emotional valence. Smaller scores indicate faster relative response time to the test stimuli vs. neutral stimuli (i.e., greater salience)
Time frame: At key points during testing: immediately after the slot machine, at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH GAM words under placebo | 95.0 percentage of neutral categorized words | Standard Deviation 4.9 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots NEG words under placebo | 93.0 percentage of neutral categorized words | Standard Deviation 10.4 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots-GAM words under drug | 91.6 percentage of neutral categorized words | Standard Deviation 7.9 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH POS words under placebo | 98.4 percentage of neutral categorized words | Standard Deviation 4.7 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH NEG words under placebo | 99.0 percentage of neutral categorized words | Standard Deviation 6.5 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots NEG words under drug | 89.1 percentage of neutral categorized words | Standard Deviation 9.5 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots ALC words under placebo | 94.8 percentage of neutral categorized words | Standard Deviation 6.1 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH ALC words under placebo | 99.9 percentage of neutral categorized words | Standard Deviation 6.2 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots POS words under drug | 91.3 percentage of neutral categorized words | Standard Deviation 8.7 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH GAM words under drug | 96.7 percentage of neutral categorized words | Standard Deviation 3.4 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots GAM words under placebo | 91.6 percentage of neutral categorized words | Standard Deviation 8.1 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH ALC words under drug | 101.2 percentage of neutral categorized words | Standard Deviation 3.6 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots POS words under placebo | 92.7 percentage of neutral categorized words | Standard Deviation 8.1 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH POS words under drug | 98.2 percentage of neutral categorized words | Standard Deviation 3.3 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | post-slots-ALC words under drug | 95.5 percentage of neutral categorized words | Standard Deviation 8.4 |
| Haloperidol - Pathological Gamblers | Cognitive Task Performance | peak AMPH NEG words under drug | 99.5 percentage of neutral categorized words | Standard Deviation 5.1 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH ALC words under drug | 99.5 percentage of neutral categorized words | Standard Deviation 4.6 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH GAM words under placebo | 97.9 percentage of neutral categorized words | Standard Deviation 5.8 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots NEG words under drug | 96.5 percentage of neutral categorized words | Standard Deviation 7.3 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH ALC words under placebo | 99.9 percentage of neutral categorized words | Standard Deviation 5.3 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots ALC words under placebo | 99.0 percentage of neutral categorized words | Standard Deviation 7.2 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots GAM words under placebo | 95.0 percentage of neutral categorized words | Standard Deviation 5.3 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots-GAM words under drug | 94.0 percentage of neutral categorized words | Standard Deviation 6 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH POS words under placebo | 97.7 percentage of neutral categorized words | Standard Deviation 5.5 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots NEG words under placebo | 97.2 percentage of neutral categorized words | Standard Deviation 13.4 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH NEG words under placebo | 100.0 percentage of neutral categorized words | Standard Deviation 3.4 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots-ALC words under drug | 98.1 percentage of neutral categorized words | Standard Deviation 7.6 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH GAM words under drug | 95.8 percentage of neutral categorized words | Standard Deviation 4.5 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH NEG words under drug | 99.4 percentage of neutral categorized words | Standard Deviation 4.8 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | peak AMPH POS words under drug | 98.7 percentage of neutral categorized words | Standard Deviation 4.6 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots POS words under placebo | 94.9 percentage of neutral categorized words | Standard Deviation 5.8 |
| Fluphenazine - Pathological Gamblers | Cognitive Task Performance | post-slots POS words under drug | 95.3 percentage of neutral categorized words | Standard Deviation 7.6 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH POS words under placebo | 97.8 percentage of neutral categorized words | Standard Deviation 4 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots ALC words under placebo | 97.0 percentage of neutral categorized words | Standard Deviation 6.5 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH POS words under drug | 97.2 percentage of neutral categorized words | Standard Deviation 4.7 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots POS words under placebo | 93.7 percentage of neutral categorized words | Standard Deviation 6.1 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots NEG words under placebo | 92.3 percentage of neutral categorized words | Standard Deviation 4.8 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH GAM words under drug | 98.1 percentage of neutral categorized words | Standard Deviation 4.5 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH ALC words under drug | 99.1 percentage of neutral categorized words | Standard Deviation 3.9 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH NEG words under drug | 96.8 percentage of neutral categorized words | Standard Deviation 3.6 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH GAM words under placebo | 96.8 percentage of neutral categorized words | Standard Deviation 2.9 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH ALC words under placebo | 100.2 percentage of neutral categorized words | Standard Deviation 4.7 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots GAM words under placebo | 97.2 percentage of neutral categorized words | Standard Deviation 7.2 |
| Haloperidol - Controls | Cognitive Task Performance | peak AMPH NEG words under placebo | 98.1 percentage of neutral categorized words | Standard Deviation 5.7 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots-GAM words under drug | 94.8 percentage of neutral categorized words | Standard Deviation 6.1 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots-ALC words under drug | 96.5 percentage of neutral categorized words | Standard Deviation 6.6 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots POS words under drug | 93.7 percentage of neutral categorized words | Standard Deviation 8.3 |
| Haloperidol - Controls | Cognitive Task Performance | post-slots NEG words under drug | 89.6 percentage of neutral categorized words | Standard Deviation 7.6 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots GAM words under placebo | 92.1 percentage of neutral categorized words | Standard Deviation 5.3 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots-GAM words under drug | 91.0 percentage of neutral categorized words | Standard Deviation 7.9 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH POS words under drug | 96.3 percentage of neutral categorized words | Standard Deviation 4.7 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH ALC words under drug | 100.3 percentage of neutral categorized words | Standard Deviation 5.4 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots NEG words under drug | 87.9 percentage of neutral categorized words | Standard Deviation 10.2 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots-ALC words under drug | 93.1 percentage of neutral categorized words | Standard Deviation 8.9 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots NEG words under placebo | 84.7 percentage of neutral categorized words | Standard Deviation 6.7 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH GAM words under placebo | 96.9 percentage of neutral categorized words | Standard Deviation 5.3 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots ALC words under placebo | 93.3 percentage of neutral categorized words | Standard Deviation 4.7 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots POS words under drug | 88.3 percentage of neutral categorized words | Standard Deviation 8.4 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH GAM words under drug | 97.0 percentage of neutral categorized words | Standard Deviation 5.9 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH POS words under placebo | 95.1 percentage of neutral categorized words | Standard Deviation 3.3 |
| Fluphenazine - Controls | Cognitive Task Performance | post-slots POS words under placebo | 86.8 percentage of neutral categorized words | Standard Deviation 10.3 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH NEG words under placebo | 96.7 percentage of neutral categorized words | Standard Deviation 4.4 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH ALC words under placebo | 97.5 percentage of neutral categorized words | Standard Deviation 6.5 |
| Fluphenazine - Controls | Cognitive Task Performance | peak AMPH NEG words under drug | 98.7 percentage of neutral categorized words | Standard Deviation 5.2 |
Secondary
Diastolic Blood Pressure (DBP)
Measure changes from baseline, especially physiologic reactivity to the slot machine and amphetamine.
Time frame: At key points in testing: immediately after the slot machine game (change from session baseline), and at expected peak subjective-behavioral effects for amphetamine (90-minutes post-capsule administration)(change from session baseline).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-to-post slot machine | 20.2 mm Hg | Standard Deviation 24.5 |
| Haloperidol - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-to-post slot machine | 22.5 mm Hg | Standard Deviation 24.8 |
| Haloperidol - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-amphetamine to peak amph | 27.2 mm Hg | Standard Deviation 24.4 |
| Haloperidol - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-amphetamine to peak amp | 33.6 mm Hg | Standard Deviation 29.8 |
| Fluphenazine - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-to-post slot machine | 21.6 mm Hg | Standard Deviation 29.3 |
| Fluphenazine - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-amphetamine to peak amph | 32.1 mm Hg | Standard Deviation 25.1 |
| Fluphenazine - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-amphetamine to peak amp | 35.2 mm Hg | Standard Deviation 28 |
| Fluphenazine - Pathological Gamblers | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-to-post slot machine | 22 mm Hg | Standard Deviation 23.6 |
| Haloperidol - Controls | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-amphetamine to peak amph | 28.5 mm Hg | Standard Deviation 30 |
| Haloperidol - Controls | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-to-post slot machine | 19.1 mm Hg | Standard Deviation 24.8 |
| Haloperidol - Controls | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-amphetamine to peak amp | 26.6 mm Hg | Standard Deviation 24.5 |
| Haloperidol - Controls | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-to-post slot machine | 15.1 mm Hg | Standard Deviation 18.6 |
| Fluphenazine - Controls | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-amphetamine to peak amp | 36.3 mm Hg | Standard Deviation 28.3 |
| Fluphenazine - Controls | Diastolic Blood Pressure (DBP) | Placebo-Change in DBP pre-to-post slot machine | 19 mm Hg | Standard Deviation 23.4 |
| Fluphenazine - Controls | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-to-post slot machine | 23.6 mm Hg | Standard Deviation 23.8 |
| Fluphenazine - Controls | Diastolic Blood Pressure (DBP) | Drug-Change in DBP pre-amphetamine to peak amph | 32.7 mm Hg | Standard Deviation 30 |
Secondary
Speed of Play on Slot Machine Game
Number of individual spins in a 15-minute slot machine game. Each spin corresponds to one wager.
Time frame: 15-minutes
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Speed of Play on Slot Machine Game | Spins/15-minutes under Drug | 76.9 individual spins/15-minutes | Standard Deviation 35.4 |
| Haloperidol - Pathological Gamblers | Speed of Play on Slot Machine Game | Spins/15-minutes under Placebo | 88.6 individual spins/15-minutes | Standard Deviation 32.9 |
| Fluphenazine - Pathological Gamblers | Speed of Play on Slot Machine Game | Spins/15-minutes under Placebo | 68.4 individual spins/15-minutes | Standard Deviation 47.3 |
| Fluphenazine - Pathological Gamblers | Speed of Play on Slot Machine Game | Spins/15-minutes under Drug | 78.5 individual spins/15-minutes | Standard Deviation 34.5 |
| Haloperidol - Controls | Speed of Play on Slot Machine Game | Spins/15-minutes under Drug | 66.4 individual spins/15-minutes | Standard Deviation 27.9 |
| Haloperidol - Controls | Speed of Play on Slot Machine Game | Spins/15-minutes under Placebo | 72.2 individual spins/15-minutes | Standard Deviation 40.5 |
| Fluphenazine - Controls | Speed of Play on Slot Machine Game | Spins/15-minutes under Drug | 71.8 individual spins/15-minutes | Standard Deviation 30.5 |
| Fluphenazine - Controls | Speed of Play on Slot Machine Game | Spins/15-minutes under Placebo | 66.7 individual spins/15-minutes | Standard Deviation 31.6 |
Secondary
Winnings on Slot Machine Upon Completion of Game
Credits
Time frame: 15-minutes
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Haloperidol - Pathological Gamblers | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under drug | 239 credits | Standard Deviation 305.1 |
| Haloperidol - Pathological Gamblers | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under Placebo | 562.4 credits | Standard Deviation 658 |
| Fluphenazine - Pathological Gamblers | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under Placebo | 140.8 credits | Standard Deviation 325.7 |
| Fluphenazine - Pathological Gamblers | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under drug | 277.8 credits | Standard Deviation 300.2 |
| Haloperidol - Controls | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under Placebo | 339.2 credits | Standard Deviation 427.4 |
| Haloperidol - Controls | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under drug | 449.1 credits | Standard Deviation 669.6 |
| Fluphenazine - Controls | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under Placebo | 215 credits | Standard Deviation 214.8 |
| Fluphenazine - Controls | Winnings on Slot Machine Upon Completion of Game | Winnings (Final Credit Tally) under drug | 544.3 credits | Standard Deviation 820 |