Treating Compulsive Buying Disorder

Based on the available evidence, we would offer a Compulsive Buying Disorder (CBD) patient the choice of a 12-session trial of Cognitive Behavioral Therapy (CBT) targeting CBD, or a seven-week trial of pharmacotherapy with citalopram. We would treat any co-morbid psychiatric disorder with appropriate psychotherapy or pharmacotherapy, and evaluate the need for couples or family therapy, and for inpatient treatment of suicidality, or comorbid conditions. We would also encourage the use of educational self-help materials. Patients preferring pharmacotherapy would be encouraged to take steps to help control CBD behaviors, e.g., identify the needs over-shopping is meeting and design more rational ways to meet them; find other ways to experience pleasure; take a “truly needed” shopping list along and purchase only these items; leave credit cards at home; avoid shopping alone—a friend may curtail compulsive buying; avoid shopping malls or other personally tempting venues; resist the convenience of online shopping and don’t allow websites to store credit card information, as this makes transactions even speedier and thus more dangerous; keep a daily journal of purchases and expenditures and of the irrational thoughts and feelings driving compulsive buying, and use self-help materials to combat them; reward yourself for exerting control. During medication visits, we would inquire regarding any difficulties in implementing these behavioral changes, and help problem-solve these difficulties. If an adequate CBT trial were ineffective, we would recommend a pharmacotherapy trial. If an adequate pharmacotherapy trial (with or without the informal behavioral therapy approaches listed) were ineffective, we would recommend a formal CBT trial. If this trial also failed, we would offer the patient sequential trials of emerging drug therapies (e.g., naltrexone and memantine). We would encourage patients to continue an effective treatment for a year (i.e., with “booster sessions” of CBT or continued drug therapy), to firmly establish the new shopping habits. © 2014, Springer International Publishing AG.