By LINLEY ERIN HALL
Researchers at medical center are starting the first placebo-controlled trial of a drug to treat kleptomania, a mental illness characterized by uncontrollable urges to steal.
More than 1.2 million people in the United States may suffer from kleptomania, which begins by age 20 in about half of reported cases and may be triggered by stress. Kleptomaniacs steal impulsively, and they usually take inexpensive items they could pay for. Often they experience intense guilt after the theft and do not use the item. In contrast, most thieves steal for profit, take valuable items, plan in advance and experience no guilt.
Clinical studies of the illness have included more female than male participants, though more men are arrested for stealing. This disparity could result from judges being more lenient toward women, said Lorrin Koran, MD, professor of psychiatry and leader of the study. Kleptomania is a misdemeanor; those convicted usually perform community service rather than serve prison time.
The study will examine whether a selective serotonin reuptake inhibitor, or SSRI, currently on the market for treating depression can reduce stealing in kleptomaniacs. Koran has led several studies of a similar drug for treatment of compulsive shopping, a disorder in which sufferers cannot stop buying items. In one of those studies, nearly 75 percent of the patients significantly reduced their shopping while on the drug. Koran hopes to see similar results in the new kleptomania trial.
Because researchers often have problems recruiting people into placebo-controlled trials, where participants may or may not get the drug, all participants in the kleptomania study will receive the drug for the first seven weeks. Those who respond favorably — with a significant decrease in stealing and no side effects that cause them to want to discontinue treatment — will be randomized into active drug and placebo groups for the next 17 weeks. Throughout the trial all patients will be asked to keep a log tracking their kleptomania incidents and the intensity of their urges to steal as well as fill out psychiatric questionnaires to determine how well the drug is working.
The study is the first placebo-controlled trial of a drug treatment for kleptomania ever conducted. "The delay is partly because kleptomaniacs are reluctant to come for care. Their behavior is illegal, and they fear being turned in," Koran said. Psychiatrists are not required to report a patients’ stealing behavior to the police, and in the study all patient information will be kept confidential.
Anyone who is age 20 or older and has had kleptomania for at least one year can volunteer. People interested in volunteering can contact the study office at 725-5180.
Funds for the study come from Forest Laboratories, which makes the drug. Koran is in the company’s speaker bureau.
Drug offers promising lead in treating compulsive urge to shop (12/13/00)
Stanford Report, October 9, 2002