Behavioral Addictions _ _______________________________________________________________________
TREATMENT In patients with Parkinson disease, behavioral addiction symptoms improve after decreasing or discontinuing dopamine agonists; however, many patients do not tolerate replacement with levodopa for treatment of motor symptoms. Compared with patients without impulse control disorders, patients with Parkinson disease and impulse control disorders are at increased risk for dopamine agonist withdrawal syndrome, characterized by craving, autonomic, and psychiatric symp- toms. Efforts to manage behavioral addiction symptoms while maintaining dopamine agonist therapy have been evaluated with amantadine and naltrexone. Research shows mixed or incomplete response. Preclinical studies identified possible efficacy with the atypical antidepressant mirtazapine [357]. Continuous levodopa delivery has improved impulse control disorder symptoms and compulsive medication use. Continu- ous delivery of apomorphine improved pre-existing impulse control disorders, but novel or additional addictive behaviors may develop. Case reports indicate the antipsychotic agent clozapine is potentially useful [357]. CONCLUSION The concept of non-substance behavioral addiction has grown in public awareness and clinical acceptance. While published research over the past decade has dramatically increased, confusion surrounds many aspects of this emerging field in behavioral health. The best available evidence has clarified several characteristics of behavioral addictions, including clinical management and how behavioral addictions resemble and differ from impulsivity, compulsivity, and substance use disorders in phenomenology and neural and cognitive features. Neuroimaging and neuropsychologic research have shown changes in brain structure and function associated with dysfunctional cognitive, affective, and behavioral processes in behavioral addictions. These findings are now forming the basis of targeted psychological and pharmacologic therapies in these patients.
WORKS CITED https://qr2.mobi/behavioral-addictions
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