Pharmacologic Treatment of Impulse Control Disorders

Abstract

toward rapid, unplanned reactions to either internal or external stimuli with diminished regard for negative consequences. Given this definition, multiple psychiatric disorders might be characterized as exhibiting problems with impulse control. In the fourth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV-TR), the category “impulse control disorders not elsewhere classified” includes pathologic gambling (PG), trichotillomania, intermittent explosive disorder (IED), kleptomania, and pyromania. Despite high prevalence rates in the general population, impulse control disorders have been relatively understudied. The disorder that arguably has been the best researched (i.e., PG) has been systematically investigated only recently with respect to empirically supported pharmacologic treatments. Because rigorous research is particularly limited for pyromania, this article will review the available research on the treatment of PG, trichotillomania, IED, and kleptomania. PATHOLOGIC GAMBLING PG is characterized by persistent and recurrent maladaptive patterns of gambling behavior and is associated with impaired functioning, reduced quality of life, decreased work productivity, and high rates of bankruptcy and relationship problems. PG usually begins in adolescence or early adulthood, with males tending to start at an earlier age. In epidemiologic studies, women represent approximately 32% After reading this article, the practitioner should be able to: