Objective. To study the antidepressant agomelatine (M1/M2 agonist and 5-HT2C antagonist) in pathological gambling (PG) (ICD-10 item F63.0). Material and methods. An open label 8-week trial was carried out in 22 outpatients (17 male and 5 female, mean age 38±7). PG severity was assessed by the Yale—Brown Obsessive-Compulsive Scale adapted for Pathological Gambling (PG-YBOCS). Anxiety and depression level was measured by the Hospital Anxiety Depression Scale (HADS). Results. Agomelatine significantly decreased PG-YBOCS scores from the second week of the trial (12.6±3.0 compared to 24.2±2.1 at baseline, p<0.05). In the end of the trial, PG-YBOCS score decreased to 5.3. The total HADS score decreased significantly in the end of the study (from 23.6±2.9 to 11.4±1.9, p<0.05). There was an improvement in behavior as well. Conclusion. Thus, agomelatine has demonstrated efficacy in PG patients.