Bupropion Shows Different Effects on Brain Functional Connectivity in Patients With Internet-Based Gambling Disorder and Internet Gaming Disorder

Abstract

IntroductionInternet gaming disorder (IGD) and gambling disorder (GD) share similar clinical characteristics but show different brain functional connectivity patterns. Bupropion is known to be effective for the treatment of patients with IGD and GD. We hypothesized that bupropion may be effective for the treatment of Internet-based gambling disorder (ibGD) and IGD and that the connections between the default mode network (DMN) and cognitive control network (CCN) would be different between ibGD and IGD patients after 12 weeks of bupropion treatment.Methods16 patients with IGD, 15 patients with ibGD, and 15 healthy subjects were recruited in this study. At baseline and after 12 weeks of bupropion treatment, the clinical symptoms of patients with IGD or ibGD were assessed, and brain activity was evaluated using resting state functional magnetic resonance imaging.ResultsAfter the 12-week bupropion treatment, clinical symptoms, including the severity of IGD or GD, depressive symptoms, attention, and impulsivity improved in both groups. In the IGD group, the functional connectivity (FC) within the posterior DMN as well as the FC between the DMN and the CCN decreased following treatment. Moreover, the FC within the DMN in the IGD group was positively correlated with changes in Young Internet Addiction Scale scores after the bupropion treatment period. In the ibGD group, the FC within the posterior DMN decreased while the FC within the CCN increased after the bupropion treatment period. Moreover, the FC within the CCN in the ibGD group was significantly greater than that in the IGD group.ConclusionBupropion was effective in improving clinical symptoms in patients with IGD and ibGD. However, there were differences in the pharmacodynamics between the two groups. After 12 weeks of bupropion treatment, the FC within the DMN as well as between the DMN and CCN decreased in patients with IGD, whereas the FC within the CCN increased in patients with ibGD.

Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review

“…In relation to therapeutic approaches to IGD, several studies investigated the potential utility of different psychopharmacological agents, but, currently, no medication has been approved for this condition [ 24 , 46 ]. As far as antidepressants are concerned, the administration of Bupropion has shown a reduction of average time spent online and craving dimension in open-label [ 47 , 48 ] and randomized controlled studies [ 49 ]. Two open trials comparing the effectiveness of Bupropion and Escitalopram showed that both antidepressants were effective in reducing IGD symptoms, though Bupropion was more effective in improving attention and in impulsivity decrease [ 50 , 51 ].…”

“…Specific evidence on the utility of pharmacological therapy in OGD is scarce. Of note, a 12-week open-label study on 14 patients treated with Bupropion up to 300 mg/day highlighted a significant improvement of clinical symptoms [ 47 ]. In terms of psychotherapeutic interventions, a recent study demonstrated that Internet based CBT could improve access to treatment among non-help -seeking online gamblers [ 91 ].…”

A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder

“…Bupropion was the most studied drug for IGD. Although there were concerns such as small sample size and short duration, two RCTs 38,40 and three additional studies 37,39,41 reported the efficacy of bupropion consistently. The efficacy of MPH and ATM treatment was also identified in two studies; 47,48 however, their effects have not been compared to those of a place- 37,41 combining functional neuroimaging showed that bupropion attenuated RSFC within the DMN and the SN and the neural response of the DLPFC to gaming cues.…”

Current approaches to the treatment and correction of Internet addiction

“…В недавно проведенном исследовании корейских ученых [32] была подтверждена эффективность бупропиона в плане снижения выраженности проявлений ИА у пациентов с ИИР и интернет-гемблингом, а также депрессии, нарушений внимания и импульсивности. Вместе с тем авторы отметили различную фармакодинамику препарата у пациентов этих двух групп по данным фМРТ.…”