Sá Rafael Richard Clorado de, Coelho Sophie, Parmar Puneet Kaur, Johnstone Samantha, Kim Hyoun Soo, Tavares Hermano
Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Department of Psychology, York University, Toronto, ON, Canada.
Psychiatry Investig. 2023 Aug;20(8):696-706. doi: 10.30773/pi.2022.0297. Epub 2023 Aug 11.
Internet gaming disorder (IGD) is an increasingly common behavioral addiction, with an estimated global prevalence of 3%. A variety of pharmacological treatments have been used to treat IGD, yet no review to date has synthesized clinical trials evaluating their efficacy. This systematic review therefore synthesized the literature reporting on clinical trials of pharmacological treatments for IGD.
We reviewed articles from MEDLINE, Embase, PubMed Central, CINAHL, and PsycINFO that were published as of March of 2022. A total of 828 articles were retrieved for review and 12 articles were included, reporting on a total of 724 participants.
Most participants were male (98.6%), and all were currently living in South Korea. The most common drugs used to treat IGD were bupropion, methylphenidate, and a range of selective serotonin reuptake inhibitors. The Young Internet Addiction Scale was the most frequently used to measure gaming-related outcomes. All studies reported reduced symptoms of IGD from pre- to post-treatment. Across all clinical trials, IGD symptom reductions following the administration of pharmacological treatments ranged from 15.4% to 51.4%. A risk of bias assessment indicated that only four studies had a low risk of bias.
Preliminary results suggest that a wide array of pharmacological interventions may be efficacious in the treatment of IGD. Future studies using double-blind randomized controlled trial designs, recruiting larger and more representative samples, and controlling for psychiatric comorbidities are needed to better inform understanding of pharmacological treatments for IGD.
网络成瘾障碍（IGD）是一种日益常见的行为成瘾，全球患病率估计为3%。多种药物治疗已被用于治疗IGD，但迄今为止尚无综述综合评估其疗效的临床试验。因此，本系统综述综合了关于IGD药物治疗临床试验的文献报道。
我们检索了截至2022年3月发表在MEDLINE、Embase、PubMed Central、CINAHL和PsycINFO上的文章。共检索到828篇文章进行综述，纳入12篇文章，共报道724名参与者。
大多数参与者为男性（98.6%），且均居住在韩国。用于治疗IGD最常用的药物是安非他酮、哌甲酯和一系列选择性5-羟色胺再摄取抑制剂。青少年网络成瘾量表是最常用于测量与游戏相关结果的量表。所有研究均报告治疗前后IGD症状减轻。在所有临床试验中，药物治疗后IGD症状减轻幅度在15.4%至51.4%之间。偏倚风险评估表明，只有四项研究偏倚风险较低。
初步结果表明，多种药物干预可能对IGD治疗有效。未来需要采用双盲随机对照试验设计、招募更大且更具代表性的样本并控制精神疾病共病情况的研究，以更好地了解IGD的药物治疗。
