Exploring the Best Drug for Kleptomania: Treatment Options and Effectiveness

October 9, 2025 •

4 min read

According to the DSM-5, kleptomania is an impulse control disorder affecting an estimated 0.3 to 0.6 percent of the general population. Finding the right treatment is crucial, but what is the best drug for kleptomania? It's important to understand that no single medication is universally considered the "best," as treatment is often highly personalized.

Quick Summary

Explores pharmacological options for treating kleptomania, including SSRIs, naltrexone, and mood stabilizers. Discusses the efficacy of combined medication and psychotherapy, and highlights that no single best drug exists.

Key Points

Personalized Treatment: There is no one-size-fits-all approach; the best medication depends on the individual's specific symptoms and co-occurring conditions.
SSRIs as First-Line: Selective Serotonin Reuptake Inhibitors like fluoxetine and paroxetine are often the initial medication choice, particularly when comorbid anxiety or depression is present.
Naltrexone for Urge Control: Naltrexone, an opioid antagonist, is effective by blocking the pleasure and reward associated with stealing, making it a strong option for reducing urges.
Therapy is Crucial: Medication is most effective when combined with psychotherapy, such as cognitive-behavioral therapy (CBT), which addresses the underlying behavioral patterns.
No FDA-Approved Drug: Currently, no medication is specifically FDA-approved for the treatment of kleptomania, though several are used off-label based on clinical evidence and mechanism of action.
Address Comorbidities: Treatment success often depends on also addressing other psychiatric conditions, such as depression, anxiety, or substance abuse, which frequently co-occur with kleptomania.

The treatment of kleptomania, a complex impulse control disorder, typically involves a multifaceted approach combining psychotherapy and medication. A common misconception is that a single "best drug" exists to cure the condition. In reality, the most effective treatment plan is tailored to the individual, taking into account comorbid conditions like depression, anxiety, or substance use disorders. A key component of treatment is managing the underlying neurobiological mechanisms, such as dysfunctions in the serotonergic and opioid systems, through medication.

First-Line Medications: Selective Serotonin Reuptake Inhibitors (SSRIs)

For many years, Selective Serotonin Reuptake Inhibitors (SSRIs) have been a primary pharmacological choice for kleptomania, primarily due to their effectiveness in treating other obsessive-compulsive spectrum disorders. Since kleptomania is believed to involve a dysfunctional serotoninergic mechanism, SSRIs work by increasing the levels of serotonin in the brain, which can help regulate mood and reduce impulsive behaviors.

Commonly prescribed SSRIs for kleptomania include:

Fluoxetine (Prozac): Often considered a first-line agent, especially for individuals with co-occurring anxiety or depression. Effective doses may be higher than those used for depression alone.
Paroxetine (Paxil): Another first-line SSRI that can help control urges and stabilize mood.
Sertraline (Zoloft) and Escitalopram (Lexapro): These are also frequently used, and their suitability depends on the patient's specific symptom profile and tolerability.

While effective for many, SSRIs may not work for everyone. Response rates vary, and in some cases, symptoms may return if medication is discontinued.

The Role of Opioid Antagonists: Naltrexone

For some individuals, especially those with strong cravings or a history of substance use, opioid antagonists like naltrexone may be more effective. Naltrexone works by blocking the "reward" or pleasure centers in the brain, thereby diminishing the gratification experienced during the act of stealing. This pharmacological approach targets the reinforcing aspect of the behavior, which is a key driver for those with kleptomania. Clinical studies have demonstrated that naltrexone can significantly reduce both the urge to steal and the actual stealing behavior compared to a placebo.

Second-Line and Augmentation Treatments

When first-line treatments like SSRIs are ineffective or not well-tolerated, or in cases of treatment-resistant kleptomania, other medications may be considered. These often include:

Mood Stabilizers: Medications such as lithium or divalproex sodium (Depakote) may be used, particularly if the person has a co-occurring mood disorder like bipolar disorder.
Atypical Antidepressants: Drugs like bupropion (Wellbutrin) or venlafaxine (Effexor) may be tried. Bupropion affects dopamine and norepinephrine, which can influence impulse control.
Anticonvulsants: Topiramate (Topamax) is an anticonvulsant that has shown some benefit in case reports for kleptomania, either alone or combined with SSRIs.
Tricyclic Antidepressants: Clomipramine (Anafranil), a tricyclic antidepressant effective for OCD, is sometimes used for severe cases of kleptomania.

Combining Medication with Psychotherapy

It is widely understood that medication is most effective when combined with psychological interventions, particularly cognitive-behavioral therapy (CBT). CBT helps individuals identify the triggers for their impulsive behavior and develop healthier coping strategies. Techniques used in CBT for kleptomania include:

Systematic Desensitization: Gradually exposing the individual to situations that trigger the urge to steal while practicing relaxation techniques.
Covert Sensitization: Imagining the negative consequences of stealing to weaken the impulse.
Aversion Therapy: Linking the urge to steal with an unpleasant stimulus, such as holding one's breath until it becomes painful.

Working with a qualified mental health professional is essential for developing a comprehensive and effective treatment plan. For more information on the effectiveness of SSRIs in treating obsessive-compulsive spectrum disorders, including kleptomania, visit the National Institutes of Health (NIH) website.

Comparing Medications for Kleptomania


Medication Class	Examples	Mechanism of Action	Typical Role in Treatment
SSRIs	Fluoxetine, Paroxetine, Sertraline	Increase serotonin levels in the brain to regulate mood and impulsivity	First-line treatment, especially with comorbid mood/anxiety disorders
Opioid Antagonists	Naltrexone	Blocks opioid receptors, reducing the euphoric "rush" associated with stealing	Alternative or augmentation for patients unresponsive to SSRIs or with substance use history
Mood Stabilizers	Lithium, Divalproex	Helps stabilize moods and reduce impulsive behaviors	For treatment-resistant cases or comorbid bipolar disorder

Conclusion: No Single Best Drug, but Effective Options Exist

There is no single best drug for kleptomania, and a pharmacological approach is most effective when personalized to the individual and combined with psychotherapy. First-line treatments typically involve SSRIs, which target the serotonergic system, while naltrexone, an opioid antagonist, has shown significant success in blocking the rewarding effects of stealing. The choice of medication depends on the individual's specific symptoms, presence of comorbidities, and treatment response. Consistent therapy and follow-up with a mental health professional are crucial for managing symptoms and preventing relapse.

Frequently Asked Questions

Selective Serotonin Reuptake Inhibitors (SSRIs) are the primary class of medications used to treat kleptomania, often selected for their effectiveness in managing other obsessive-compulsive spectrum disorders.

Yes, naltrexone has been shown to be an effective drug for treating kleptomania. Clinical studies indicate that it can significantly reduce both the urges to steal and the stealing behavior by blocking the brain's reward system.

No, currently there are no medications that are specifically FDA-approved for the treatment of kleptomania. The drugs used are often prescribed off-label based on clinical evidence and their effectiveness for similar conditions.

Medications for kleptomania help regulate the underlying neurobiological and biochemical abnormalities in the brain, such as those involving serotonin and the opioid system, to reduce the impulsive urge to steal.

Medication alone is not typically sufficient. The most effective treatment plans for kleptomania involve a combination of medication and psychotherapy, such as Cognitive Behavioral Therapy (CBT).

Kleptomania cannot be cured, but like other chronic mental illnesses, it can be effectively managed with ongoing treatment involving both medication and therapy. Discontinuing treatment can lead to a relapse of symptoms.

If a patient does not respond adequately to SSRIs, a doctor may try switching to a different SSRI, or consider alternative medications such as opioid antagonists (naltrexone), mood stabilizers (lithium), or anticonvulsants (topiramate).