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Treatments and drugs
By Mayo Clinic staffAlthough fear, humiliation or embarrassment may make it difficult for you to seek treatment for kleptomania, it's important to get help. Kleptomania is very difficult to overcome on your own. Treatment of kleptomania typically involves medications and psychotherapy, perhaps along with self-help groups. However, there's no standard kleptomania treatment and researchers are still trying to understand what may work best. You may have to try several types of kleptomania treatment to find something that works well for your situation.
Medications
There's little solid scientific research about using psychiatric medications to treat kleptomania. However, some studies have suggested that certain medications may be helpful. Which medication is best for you depends on your overall situation and other conditions you may have, such as depression or obsessive-compulsive disorder. You may benefit from taking a combination of medications. Medications to consider include:
- Antidepressants. Those most commonly used to treat kleptomania are selective serotonin reuptake inhibitors (SSRIs). These include fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR), fluvoxamine and others. However, there have been a few case reports of SSRIs actually triggering kleptomania symptoms. Talk to your doctor about your concerns and coping with side effects of antidepressants.
- Mood stabilizers. These medications are meant to even out your mood so that you don't have rapid or uneven changes that may trigger urges to steal. Some evidence suggests that lithium (Eskalith, Lithobid) may be helpful.
- Benzodiazepines. These medications are central nervous system depressants, also called tranquilizers. They include clonazepam (Klonopin) and alprazolam (Xanax, Niravam). The effectiveness of benzodiazepines often varies, and they may be habit-forming — causing mental or physical dependence, especially when taken for a long time or in high doses.
- Anti-seizure medications. Although originally intended for seizure disorders, these medications have shown benefits in certain mental health disorders, possibly including kleptomania. Some studies have shown benefits from topiramate (Topamax) and valproic acid (Depakene, Stavzor).
- Addiction medications. Naltrexone (Revia), known technically as an opioid antagonist, blocks the part of your brain that feels pleasure with certain addictive behaviors. It may reduce the urges and pleasure associated with stealing.
You may have to try several different medications or combinations of medications to see what works best for you with the fewest side effects. Keep in mind that it may take several weeks to notice full benefits. Talk to your doctor or mental health provider if you're bothered by side effects. Under his or her guidance, you may be able to switch medications or change your dosage. Many side effects go away on their own with time.
Psychotherapy
Cognitive behavioral therapy has become the psychotherapy of choice for kleptomania. In general, cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. Cognitive behavioral therapy may include these techniques to help you overcome kleptomania urges:
- Covert sensitization, in which you picture yourself stealing and then facing negative consequences, such as being caught.
- Aversion therapy, in which you practice mildly painful techniques, such as holding your breath until you become uncomfortable, when you get an urge to steal.
- Systematic desensitization, in which you practice relaxation techniques and picture yourself controlling urges to steal.
Other forms of therapy, such as psychodynamic therapy, family therapy or marriage counseling, also may be helpful.
Avoiding relapses
It's not unusual to have relapses of kleptomania. To help avoid relapses, be sure to stick to your treatment plan. If you feel urges to steal, contact your mental health provider or reach out to a trusted support group. If you're on probation, you may also consider touching base with a trusted and compassionate probation officer.
- Kleptomania. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 31, 2009.
- Hollander E, et al. Impulse-control disorders not elsewhere classified. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed July 31, 2009.
- Gendel MH. Impulse-control disorders. In: Jacobsen JL, et al. Psychiatric Secrets. 2nd ed. Philadelphia, Pa.: Hanley & Belfus; 2001. http://www.mdconsult.com/das/book/body/152310510-3/869709846/1167/66.html#4-u1.0-B1-56053-418-4..50033-9--cesec9_630. Accessed July 31, 2009.
- Kleptomania. In: Moore DP, et al. Handbook of Medical Psychiatry. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/125211023-6/0/1243/85.html?tocnode=52436571&fromURL=85.html#4-u1.0-B0-323-02911-6..X5001-5--section6_797. Accessed July 31, 2009.
- Aizer A. Kleptomania after head trauma: Two case reports and combination treatment. Clinical Neuropharmacology. 2004;27:211.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 10, 2009.
