Dopamine and Gambling Disorder: Prospects for Personalized Treatment
Purpose of Review
To address variation in the severity of gambling disorder, this review evaluates the contribution of mesocorticolimbic dopamine neurons to potential behavioral endophenotypes, the influence of individual differences in the dopamine system on gambling and related behaviors, and the possible role for dopaminergic medications in the treatment of gambling disorder.
Newer work has suggested that dopaminergic dysfunction can lead to increased reward anticipation and a greater sensitivity to uncertainty, which in turn may drive addictive gambling behaviors. In addition, increased impulsivity, a well-recognized risk factor for gambling disorder, has been linked to dopaminergic dysfunction. More recently, emerging evidence has suggested that dopaminergic medications can influence the discounting of delayed rewards.
Dopaminergic drugs that increase the salience of long-term over short-term goals may ameliorate symptoms of impulsive individuals with gambling disorder. More broadly, improved understanding of intermediate behavioral and other phenotypes with a defined neurobiological substrate may allow for personalized treatment of gambling disorder and other psychiatric conditions.
KeywordsDopamine Gambling Addiction Impulsivity Delay discounting Computational psychiatry
Thanks go to Howard Fields and Jan Peters for reading through an earlier version of this manuscript, and to the colleagues and research subjects who contributed to our studies included in this review. Of course, any errors belong to the author alone.
This work was supported by NIH grants AA026587 and MH112775.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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