Adolescents as a group appear to constitute a high-risk population for gambling problems. Given the rates of adolescent problem gambling and its impact on affected individuals and their families, effective treatments are important. There are, however, no pharmacological treatments for pathological gambling in children, adolescents, or adults that are currently approved by the United States Food and Drug Administration (FDA). Additionally, no studies have investigated directly the safety and efficacy of pharmacological treatments for pathological gambling in adolescents. This article reviews the literature on effective treatments in adults with pathological gambling, describes the safety data for the use of these drugs in adolescents, and provides a rationale for future studies to investigate the efficacy and tolerability of pharmacotherapies for pathological gambling in adolescents.