Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-25T15:38:55.664Z Has data issue: false hasContentIssue false
  • English
  • Français

Behavioral addictions: a novel challenge for psychopharmacology

Published online by Cambridge University Press:  04 March 2014

Donatella Marazziti ,
Silvio Presta ,
Stefano Baroni ,
Stefano Silvestri  and
Liliana Dell'Osso
Donatella Marazziti*
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Silvio Presta
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Stefano Baroni
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Stefano Silvestri
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Liliana Dell'Osso
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
*
*Address for correspondence: Donatella Marazziti, MD, Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Via Roma 67, 56100 Pisa, Italy. (Email: dmarazzi@psico.med.unipi.it)
Get access Rights & Permissions [Opens in a new window]

Abstract

Although addictive syndromes have been traditionally related to substance-use disorders, during the last few decades a novel addictive group, including the so-called “behavioral or no-drug addictions,” has been recognized and has attracted increasing attention for its relevant social impact. This group includes pathological gambling, compulsive shopping, TV/Internet/social network/videogame addictions, workaholism, sex and relationship addictions, orthorexia, and overtraining syndrome. Substance and behavioral addictions show similar phenomenological features, such as craving, dependence, tolerance, and abstinence, and perhaps they share a common possible pathophysiology. It is, however, controversial whether all or at least some of them should be considered real disorders or just normal, albeit extreme, behaviors. The aim of this article is to review current data on pharmacological treatment of behavioral addictions. As no specific and validated treatment algorithms are currently available, only an improved knowledge on their psychopathological, clinical, and neurobiological features may have relevant implications for more focused preventive and therapeutic strategies.

Keywords

Behavioral addictionscompulsive shoppingorthorexiaovertraining syndromepathological gamblingpsychopharmacologysex and relationship addictionsTV/Internet/social network/videogame addictionsworkaholism
Type
Review Articles
Information
CNS Spectrums , Volume 19 , Issue 6 , December 2014 , pp. 486 - 495
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.World Health Organization. International Classification of Diseases. 10thversion (ICD-10). Geneva: World Health Organization; 1994.Google Scholar
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text rev. Washington, DC: American Psychiatric Association; 2001.Google Scholar
3.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.Washington, DC: American Psychiatric Association; 2013.Google Scholar
4.Alonso-Fernandez, F. Le Altre Droghe. Rome: Edizioni Universitarie Romane; 1999.Google Scholar
5.Marazziti, D. Farmacoterapia Clinica, 5th ed.Rome: Fioriti; 2013.Google Scholar
6.Custer, RL. Profile of the pathological gambler. J Clin Psychiatry. 1984; 45: 35–38.Google ScholarPubMed
7.Grant, JE, Kim, SW, Potenza, MN. Advances in the pharmacological treatment of pathological gambling. J Gambl Stud. 2003; 19(1): 85–109.CrossRefGoogle ScholarPubMed
8.Hollander, E, Frenkel, M, Decaria, C, etal. Treatment of pathological gambling with clomipramine. Am J Psychiatry. 1992; 149(5): 710–711.Google ScholarPubMed
9.Nordin, C, Eklundh, T. Altered CSF 5-HIAA disposition in pathologic male gamblers. CNS Spectr. 1999; 4: 25–33.Google Scholar
10.Marazziti, D, Golia, F, Picchetti, M, etal. Decreased density of the platelet serotonin transporter in pathological gamblers. Neuropsychobiology. 2008; 57(1–2): 38–43.Google Scholar
11.Conversano, C, Marazziti, D, Carmassi, C, etal. Pathological gambling: a systematic review of biochemical, neuroimaging, and neuropsychological findings. Harv Rev Psychiatry. 2012; 20(3): 130–148.Google Scholar
12.Hollander, E, DeCaria, CM, Mari, E. Short-term single-blind fluvoxamine treatment of pathological gambling. Am J Psychiatry. 1998; 155(12): 1781–1783.Google Scholar
13.Hollander, E, DeCaria, CM, Finkell, JN, etal. A randomized double-blind fluvoxamine/placebo crossover trial in pathologic gambling. Biol Psychiatry. 2000; 47(9): 813–817.CrossRefGoogle ScholarPubMed
14.Blanco, C, Petkova, E, Ibáñez, A, Sáiz-Ruiz, J. A pilot placebo-controlled study of fluvoxamine for pathological gambling. Ann Clin Psychiatry. 2002; 14(1): 9–15.Google Scholar
15.Kim, SW, Grant, JE, Adson, DE, Shin, YC, Zaninelli, R. A double-blind placebo-controlled study of the efficacy and safety of paroxetine in the treatment of pathological gambling. J Clin Psychiatry. 2002; 63(6): 501–507.Google Scholar
16.Zimmerman, M, Breen, RB, Posternak, MA. An open-label study of citalopram in the treatment of pathological gambling. J Clin Psychiatry. 2002; 63(1): 44–48.Google Scholar
17.Black, DW, Shaw, M, Forbush, KT, Allen, J. An open-label trial of escitalopram in the treatment of pathological gambling. Clin Neuropharmacol. 2007; 30(4): 206–212.Google Scholar
18. DeCaria CM, Hollander E, Begas T. Reliability and validity of a pathological gambling modification of the Yale-Brown Obsessive-Compulsive Scale: Preliminary findings. Paper presented at: Third International Conference on OCD; September, 1998; Madeira, Portugal.Google Scholar
19.Pallanti, S, Baldini-Rossi, N, Sood, E. Nefazodone treatment of pathological gambling: a prospective open-label controlled trial. J Clin Psychiatry. 2002; 63(11): 1034–1039.CrossRefGoogle ScholarPubMed
20.Black, DW. An open-label trial of bupropion in the treatment of pathologic gambling. J Clin Psychopharmacol. 2004; 24(1): 108–110.CrossRefGoogle ScholarPubMed
21.McElroy, SL, Pope, HG, Keck, PE, etal. Are impulse control disorders related to bipolar disorder? Compr Psychiatry. 1996; 37(4): 229–240.CrossRefGoogle ScholarPubMed
22.Pallanti, S, Quercioli, L, Sood, E, Hollander, E. Lithium and valproate treatment of pathological gambling: a randomized single-blind study. J Clin Psychiatry. 2002; 63(7): 559–566.Google Scholar
23.Dannon, PN, Lowengrub, K, Gonopolski, Y, Musin, E, Kotler, M. Topiramate versus fluvoxamine in the treatment of pathological gambling: a randomized, blind-rater, comparison study. Clin Neuropharmacol. 2005; 28(1): 6–10.Google Scholar
24.Kim, SW, Grant, JE, Adson, DE, Shin, YC. Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling. Biol Psychiatry. 2001; 49(11): 914–921.Google Scholar
25.Grant, JE, Potenza, MN, Hollander, E, etal. Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling. Am J Psychiatry. 2006; 163(2): 303–312.Google Scholar
26.Grant, JE, Kim, SW, Odlaug, BL. N-acetyl cysteine, a glutamate-modulating agent, in the treatment of pathological gambling: a pilot study. Biol Psychiatry. 2007; 62(6): 652–657.Google Scholar
27.Olive, MF, Cleva, RM, Kalivas, PW, etal. Glutamatergic medications for the treatment of drug and behavioral addictions. Pharmacol Biochem Behav. 2012; 100(4): 801–810.Google Scholar
28.Fong, T, Kalechstein, A, Bernhard, B, etal. A double-blind, placebo-controlled trial of olanzapine for the treatment of video poker pathological gamblers. Pharmacol Biochem Behav. 2008; 89(3): 298–303.Google Scholar
29.Zack, M, Poulos, CX. Effects of the atypical stimulant modafinil on a brief gambling episode in pathological gamblers with high vs. low impulsivity. J Psychopharmacol. 2009; 23(6): 660–671.CrossRefGoogle ScholarPubMed
30.McElroy, SL, Keck, PE Jr, Pope, HG Jr, Smith, JM, Strakowski, SM. Compulsive buying: a report on 20 cases. J Clin Psychiatry. 1994; 55(6): 242–248.Google Scholar
31.McElroy, SL, Satlin, A, Pope, HG, Keck, PE, Hudson, J. Treatment of compulsive shopping with antidepressant: a report of three cases. Ann Clin Psychiatry. 1991; 3: 199–204.CrossRefGoogle Scholar
32.Lejoyeux, M, Hourtane, M, Ades, J. Compulsive buying and depression. J Clin Psychiatry. 1995; 56(1): 38.Google Scholar
33.Bullock, K, Koran, L. Psychopharmacology of compulsive buying. Drugs Today (Barc). 2003; 39(9): 695–700.CrossRefGoogle ScholarPubMed
34.Guzman, CS, Filomensky, T, Tavares, H. Compulsive buying treatment with topiramate, a case report. Rev Bras Psiquiatr. 2007; 29: 383–384.Google Scholar
35.Grant, JE, Odlaug, BL, Mooney, M, etal. Open-label pilot study of memantine in the treatment of compulsive buying. Ann Clin Psychiatry. 2012; 24(2): 119–263.Google Scholar
36. Goldberg I. Internet addictive disorder (IAD) diagnostic criteria. 1995. http://www.psycom.net/iadcriteria.html.Google Scholar
37.Young, KS. Internet addiction: symptoms, evaluation, and treatment. In Vande-Creek L, Jackson T, eds. Innovations in Clinical Practice: A Source Book. Sarasota, FL: Professional. 1996; 17: 19–31.Google Scholar
38.Han, DH, Lee, YS, Na, C, etal. The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder. Compr Psychiatry. 2009; 50(3): 251–256.Google Scholar
39.Han, DH, Hwang, JW, Renshaw, PF. Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Exp Clin Psychopharmacol. 2010; 18(4): 297–304.CrossRefGoogle ScholarPubMed
40.Bostwick, JM, Bucci, A. Internet sex addiction treated with naltrexone. Mayo Clin Proc. 2008; 83(2): 226–230.Google Scholar
41.Sattar, P, Ramaswamy, S. Internet gaming addiction. Can J Psychiatry. 2004; 49(12): 869–870.Google Scholar
42.Dell'Osso, B, Altamura, AC, Hadley, SJ, etal. An open label trial of escitalopram in the treatment of compulsive–impulsive Internet usage disorder. Eur Neuropsychopharmacol. 2006; 16(Suppl 1): 82–83.Google Scholar
43.Robinson, BE. Chained to the Desk. New York: New York University Press; 1998.Google Scholar
44.Fossum, M, Mason, M. Il Sentimento Della Vergogna. Rome: Astrolabio; 1986.Google Scholar
45.Coleman, E, Gratzer, T, Nesvacil, L, Raymond, NC. Nefazodone and the treatment of nonparaphilic compulsive sexual behavior: a retrospective study. J Clin Psychiatry. 2000; 61(4): 282–284.Google Scholar
46.Goodman, A. La Dipendenza Sessuale: Un Approccio Integrato. Rome: Astrolabio; 1998.Google Scholar
47.Griffin, SE. Sex and Love: Addiction, Treatment and Recovery. London: Praeger; 1991.Google Scholar
48.Cesnik, JA, Coleman, E. Use of lithium carbonate in the treatment of autoerotic asphyxia. Am J Psychother. 1989; 43(2): 277–285.Google Scholar
49.Coleman, E, Cesnik, J, Moore, A. An exploratory study of the role of psychotropic medications in treatment of sex offenders. Journal of Offender Rehabilitation. 1992; 18(3–4): 75–88.Google Scholar
50.Kruesi, MJ, Fine, S, Valladares, L, Phillips, RA Jr, Rapoport, JL. Paraphilias: a double-blind cross-over comparison of clomipramine versus desipramine. Arch Sex Behav. 1992; 21(6): 587–593.Google Scholar
51.Emmanuel, NP, Lydiard, RB, Ballenger, JC. Fluoxetine treatment of voyeurism. Am J Psychiatry. 1991; 148(7): 950.Google Scholar
52.Stein, DJ, Hollander, E, Anthony, DT, etal. Serotonergic medications for sexual obsessions, sexual addiction, and paraphilias. J Clin Psychiatry. 1992; 53(8): 267–271.Google Scholar
53.Fedoroff, JP. Serotonergic drugs treatment of deviant sexual interests. Annals of Sex Research. 1993; 6(2): 105–121.Google Scholar
54.Kafka, MP. Sertraline pharmacotherapy for paraphilias and paraphilia-related disorders: an open trial. Ann Clin Psychiatry. 1994; 6(3): 189–195.Google Scholar
55.Fedoroff, JP. Buspirone hydrochloride in the treatment of transvestic fetishism. J Clin Psychiatry. 1988; 49(10): 408–409.Google Scholar
56.Fedoroff, JP. Buspirone hydrochloride in the treatment of atypical paraphilia. Arch Sex Behav. 1992; 21: 401–406.Google Scholar
57.Coleman, E. The obsessive-compulsive model for describing compulsive sexual behavior. American Journal of Preventive Psychiatry and Neurology. 1990; 2(3): 9–14.Google Scholar
58.Raymond, NC, Grant, JE, Kim, SM, Coleman, E. Treatment of compulsive sexual behavior with naltrexone and serotonin reuptake inhibitors: two case studies. Int Clin Psychopharmacol. 2002; 17(4): 201–205.Google Scholar
59.Renynghe de Voxvrie, GV. Use of anafranil (g34586) in obsessive neuroses. Acta Neurol Psychiatr Belg. 1968; 68(10): 787–792; [in French].Google Scholar
60.Ananth, J, Solyom, L, Bryntwick, S, Krishnappa, U. Chlorimipramine therapy for obsessive compulsive neurosis. Am J Psychiatry. 1979; 136(5): 700–701.Google Scholar
61.Godin, Y, Heiner, L, Mark, J, Mandel, P. Effects of DI-n-propylacetate, and anticonvulsive compound, on GABA metabolism. J Neurochem. 1969; 16(3): 869–873.Google Scholar
62.Marazziti, D, Dell'Osso, B. Topiramate plus citalopram in the treatment of compulsive impulsive sexual behaviors. Clin Pract Epidemiol Ment Health. 2006; 2: 9–16.Google Scholar
63.Alger, B. Retrograde signaling in the regulation of synaptic transmission: focus on endocannabinoids. Prog Neurobiol. 2000; 68(4): 247–286.Google Scholar
64.Wilson, RI, Nicoll, RA. Endocannabinoid signaling in the brain. Science. 2002; 296(5568): 678–682.Google Scholar
65.Murphy, MR, Checkley, SA, Seckl, JR, Lightman, SL. Naloxone inhibits oxytocin release at orgasm in man. J Clin Endocrinol Metab. 1990; 71(4): 1056–1058.Google Scholar
66.Bradford, JM. The hormonal treatment of sexual offenders. Bull Am Acad Psychiatry Law. 1983; 11(2): 159–169.Google Scholar
67.Liggio, F. La terapia farmacologica della dipendenza da reazione orgasmica. In: Avenia F, Pistuddi A, eds. Manuale sulla Sexual Addiction: Definizioni, Diagnosi, Interventi. Milan: FrancoAngeli; 2007, 25–37.Google Scholar
68.Fenichel, O. The Psychoanalytic Theory of Neuroses. New York: Norton Press; 1945.Google Scholar
69.Peele, S, Brodsky, A. Love and Addiction. New York: Taplinger Publishing Co.; 1975.Google Scholar
70.Norwood, R. Women Who Love Too Much. New York: Pocket Books; 1985.Google Scholar
71.Bratman, S, Knight, D. Health Food Junkies. New York: Broadway Books; 2000.Google Scholar
72.Donini, LM, Marsili, D, Graziani, MP, etal. Orthorexia nervosa: validation of a diagnostic questionnaire. Eat Weight Disord. 2005; 10(2): 28–32.Google Scholar
73.Meeusen, R, Duclos, M, Foster, C, etal. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013; 45(1): 186–205.Google Scholar
74.Goldstein, RZ, Volkow, ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry. 2002; 159(10): 1642–1652.CrossRefGoogle ScholarPubMed
75.Goudriaan, AE, de Ruiter, MB, van den Brink, W, Oosterlaan, J, Veltman, DJ. Brain activation patterns associated with cue reactivity and craving in abstinent problem gamblers, heavy smokers and healthy controls: an fMRI study. Addict Biol. 2012; 15(4): 491–503.Google Scholar
76.Marazziti, D, Catena Dell'osso, M, Conversano, C, etal. Executive function abnormalities in pathological gamblers. Clin Pract Epidemiol Ment Health. 2008; 4(1): 7.Google Scholar
77.Gambling, Serpelloni G. Gioco d'azzardo problematico e patologico: inquadramento generale, meccanismi fisio-patologici, vulnerabilità, evidenze scientifiche per la prevenzione, cura e riabilitazione. In: Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Manuale per i Dipartimenti delle Dipendenze. Rome, Italy; 2013.Google Scholar
78.Sbrana, A, Bizzarri, JV, Rucci, P, etal. The spectrum of substance use in mood and anxiety disorders. Compr Psychiatry. 2005; 46(1): 6–13.Google Scholar
79.Bizzarri, JV, Sbrana, A, Rucci, P, etal. The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity. Bipolar Disord. 2007; 9(3): 213–220.Google Scholar