Internet sex addiction treated with naltrexone.

Malfunctioning of the brain's reward center is increasingly understood to underlie all addictive behavior. Composed of mesolimbic incentive salience circuitry, the reward center governs all behavior in which motivation has a central role, including acquiring food, nurturing young, and having sex. To the detriment of normal functioning, basic survival activities can pale in importance when challenged by the allure of addictive substances or behaviors. Dopamine is the neurotransmitter driving both normal and addictive behavior. Other neurotransmitters modulate the amount of dopamine released in response to a stimulus, with the salience determined by the intensity of the dopamine pulse. Opiates (either endogenous or exogenous) exemplify such modulators. Prescribed for treating alcoholism, naltrexone blocks opiates' capacity to augment dopamine release. This article reviews naltrexone's mechanism of action in the reward center and describes a novel use for naltrexone in suppressing a euphorically compulsive and interpersonally devastating addiction to Internet pornography.

[1]  G. H. Williams,et al.  Drug addiction. , 1957, Pennsylvania medical journal.

[2]  Suck-Won Kim,et al.  Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies. , 2002, International clinical psychopharmacology.

[3]  Eric Hollander,et al.  Impulsive-Compulsive Sexual Behavior , 2006, CNS Spectrums.

[4]  E. Nestler.  From neurobiology to treatment: progress against addiction , 2002, Nature Neuroscience.

[5]  R. Ryback.  Naltrexone in the treatment of adolescent sexual offenders. , 2004, The Journal of clinical psychiatry.

[6]  Brian M. McCarver.  Essential Psychopharmocology: Neuroscientific Basics and Practical Applications, 2nd ed. , 2001 .

[7]  K. Brady,et al.  Naltrexone treatment of self-injurious thoughts and behaviors. , 1996, The Journal of nervous and mental disease.

[8]  M. Potenza,et al.  Impulse control disorders in adult psychiatric inpatients. , 2005, The American journal of psychiatry.

[9]  Suck-Won Kim,et al.  Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling , 2001, Biological Psychiatry.

[10]  Suck-Won Kim,et al.  An open-label study of naltrexone in the treatment of kleptomania. , 2002, The Journal of clinical psychiatry.

[11]  E. Nestler.  Is there a common molecular pathway for addiction? , 2005, Nature Neuroscience.

[12]  Margaret E Balfour,et al.  Sexual Behavior and Sex-Associated Environmental Cues Activate the Mesolimbic System in Male Rats , 2004, Neuropsychopharmacology.

[13]  Jerrold S. Meyer,et al.  Psychopharmacology: Drugs, the Brain, and Behavior , 2004 .

[14]  S. Hyman.  Addiction: A Disease of Learning and Memory , 2007 .

[15]  J. Brewer,et al.  The Neurobiology of Substance and Behavioral Addictions , 2006, CNS Spectrums.

[16]  R. Beninger,et al.  Behavioural Sensitization in Addiction, Schizophrenia, Parkinson’s Disease and Dyskinesia , 2006, Neurotoxicity Research.

[17]  N. Volkow,et al.  The neural basis of addiction: a pathology of motivation and choice. , 2005, The American journal of psychiatry.

[18]  Rita Z. Goldstein,et al.  Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. , 2002, The American journal of psychiatry.

[19]  J. Grant,et al.  A Case of Kleptomania and Compulsive Sexual Behavior Treated with Naltrexone , 2001, Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists.