Imagine you’re in line at your local 7-11 to buy a newspaper and a cup of coffee. On the check out counter there’s a small display of mints. You suddenly begin to feel an overpowering anxiety that can only be calmed by doing one thing. When the cashier turns to the side for a moment, you grab a mint tin and slip it into your pocket. Your anxiety quickly turns to a sensation of satisfaction and wellbeing. After you’ve paid for your paper and coffee, you leave the store and throw the mints in the trashcan outside.
This is what life is like for people with kleptomania. They’re not shoplifters. They don’t steal because they need something or don’t have enough money. Their actions are compulsive and beyond their control. This disorder is believed to affect more than 1.2 million people in the U.S., but the number may be much higher because shame and fear prevent many kleptomaniacs from seeking help for their condition.
Recent research shows that kleptomaniacs appear to have something in common with many patients who suffer from anxiety, depression, and obsessive-compulsive disorder (OCD): They may have a serotonin dysfunction.
Something is working
A study reported in the current issue of the Journal of Clinical Psychiatry found that an antidepressant drug was no better than placebo in treating kleptomania among 15 subjects with this condition. But in an earlier phase of the study in which all subjects were aware they were taking an antidepressant, more than three quarters had favorable outcomes in controlling their impulses to steal. This result is chalked up to a placebo response.
By the strict requirements of clinical evidence, a placebo response isn’t of significance in the research community. But out here in the real world, we can put two and two together and recognize that something is going on. In fact, previous trials and case studies have shown that the type of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may help curb compulsive stealing in some patients, strengthening the theory that kleptomania and other compulsive conditions may be serotonin disorders.
In a press release from Stanford University School of Medicine where the study was conducted, lead researcher Lorrin Koran, M.D., noted that larger trials should be mounted to confirm the effectiveness of SSRIs on kleptomania. And in spite of the inconclusive results of his study, Dr. Koran added: “For some people, I think these drugs really do work.”
Serotonin is a natural hormone that transmits nerve impulses. Levels of the hormone are determined by reuptake into the pre-synaptic cell. When levels are too low, SSRIs (as the name suggests) inhibit reuptake, making more serotonin available to do its important work.
Whether you suffer from kleptomania, depression, OCD, or any related disorder, an SSRI may help. But as we’ve seen with previous studies, many patients have adverse reactions to SSRIs that range from gastrointestinal bleeding to suicidal tendencies. So before turning to this powerful synthetic drug, patients should know that supplements of omega-3 fatty acids might produce even better results.
In the e-Alert “Omega Delta Blues” (10/28/02), I told you about a British study of 70 subjects who were all diagnosed with persistent depression. None of the subjects had responded successfully to SSRI treatments such as Prozac and Zoloft. For 12 weeks, subjects received one, two, or four grams per day of ethyl-eicosapentaenoate (EPA), one of the key omega-3 fatty acids. About one quarter of the subjects received a placebo. The greatest response was observed in the group that received the one-gram daily dosage. Almost three quarters of the subjects in this group showed a 50% reduction in depression, anxiety, and suicidal tendencies.
As psychiatrist Andrew Stoll, M.D., explained in “Prevention” magazine: “All cell coatings are made of fats, and when those fats are omega-3s, the serotonin receptors on the surface of brain cells seem to function in a healthier way.”
You can find further details about treating OCD, anxiety, schizophrenia, and other mental disorders in the e-Alert “A Beautiful Mind” (2/6/07), at this link: http://www.hsionline.com/ealerts/ea200702/ea20070206a.html
“Escitalopram Treatment of Kleptomania: An Open-Label Trial Followed by Double-Blind Discontinuation” Journal of clinical Psychiatry, Vol. 68, No. 3, March 2007, psychiatrist.com
“Stanford Study Finds No Conclusive Benefit from Treating Kleptomania” Press release from Stanford University Medical Center, 3/15/07, eurekalert.org
“A Dose-Ranging Study of the Effects of Ethyl-Eicosapentaenoate in Patients With Ongoing Depression Despite Apparently Adequate Treatment With Standard Drugs” Archives of General Psychiatry, Vol. 59, No. 10, October 2002, archpsyc.ama-assn.org
“Bye-Bye, Blues – Healthy Fats Ease Depression” Holly McCord, R.D., Prevention, August 2002, prevention.com