Antidepressants Don't Help Kleptomaniacs

FRIDAY, March 16 (HealthDay News) -- Antidepressants don't help people with the compulsive stealing disorder kleptomania, a new study found.

The findings, by researchers at the Stanford University School of Medicine, came as no surprise to experts in the mental health field, where kleptomania is known as a particularly stubborn problem.

"Kleptomania doesn't respond very well to anything at all," said Dr. Norman Sussman, a professor of psychiatry at New York University School of Medicine. "Even therapy is often useless. People will steal things even after getting caught. It's truly a compulsion."

The study authors, however, did not rule out the possibility that certain medications, even the one used in the trial, might still prove to be an effective treatment for some people.

Some 1.2 million Americans are believed to suffer from kleptomania, which propels them to impulsively steal inexpensive and unneeded items. Unlike shoplifting, stealing related to kleptomania is not planned and is not motivated by need or financial gain.

According to background information in the study, kleptomania has been estimated to account for 4 percent to 10 percent of shoplifting in the United States. With shoplifting causing estimated annual losses of $10 billion to $50 billion, kleptomania's toll is substantial.

"People with kleptomania rarely seek treatment, because they're afraid of the legal consequences or don't know that treatment may help," said study author Dr. Lorrin Koran, a professor of psychiatry and behavioral sciences at Stanford. "Some people do benefit from treatment."

An earlier "open-label" trial showed a 78 percent success rate with antidepressants known as selective serotonin reuptake inhibitors (SSRIs). But open-label trials, in which information about who is taking medication and who is taking a placebo is public, are notoriously unreliable.

"In open-label trials, it only looks like they might work," Sussman said. "It's wishful thinking."

For the new study, published in the March issue of theJournal of Clinical Psychiatry, the researchers looked at 24 people aged 20 or older who had been diagnosed with kleptomania at least one year earlier.

The participants were randomly chosen to take either the SSRI escitalopram (Lexapro) or a placebo. The study was funded by Lexapro's maker, Forest Laboratories. Response rates turned out to be the same in both groups, suggesting that the earlier effects in the open-label trial were due to a placebo effect.

In the second phase of the study, conducted as a double-blind, placebo-controlled trial with 15 participants, no benefit was seen. About the same proportion of participants relapsed in each group.