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A GAMBLING WIN RAISES ACTIVITY NEAR DOPAMINE CELLS
A Win Raises Activity In A Few Specific Brain Regions
You Might Expect A Loss To Do Nothing At All
A Near Miss Raises Activity In Two Of Them
Those Two Are The Ventral Striatum And The Insula
Patients With Insula Damage Do Not Show That Effect
Dopamine Agonists For Parkinson Act On That Same Striatum
Whether Any Of It Can Be Treated Is A Separate Question
This Part Covers The Drugs The Scans And The Trials
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE LAB 🔬
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WHAT THE DRUG DATA SHOWED 💊
Researchers Screened Patients At 46 Movement Disorder Centers
Those Sites Were In The United States And Canada
The Sample Reached 3090 People
Every One Of Them Was Getting Routine Clinical Care
Raters Were Blinded To Which Medication Each Patient Took
The Team Looked For Four Impulse Control Disorders
One Of Them Was Problem Or Pathological Gambling
An Impulse Control Disorder Turned Up In 13.6 Percent
Gambling Alone Accounted For 5.0 Percent
Compulsive Buying Came To 5.7 Percent
Binge Eating Disorder Was 4.3 Percent
Compulsive Sexual Behavior Was 3.5 Percent
Two Or More Appeared In 3.9 Percent
The Rates Then Split By Medication
Patients On A Dopamine Agonist Hit 17.1 Percent
Those Not Taking One Showed 6.9 Percent
The Odds Ratio Worked Out At 2.72
Pramipexole And Ropinirole Performed Alike
The Authors Called It A Drug Class Relationship
Both Drugs Bind The Dopamine D3 Receptor
That Receptor Is Concentrated In The Ventral Striatum
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WHICH BRAIN AREAS REACT 🧠
Medication Is Only One Side Of This
A Review Turned To The Games Themselves
Most Forms Of Gambling Deliver Near Misses
Those Outcomes Look Close To A Win
They Are Objective Losses
Players Rate A Near Miss As More Aversive Than A Full Miss
It Still Increases The Desire To Keep Playing
The Increase Only Appears When Players Choose Their Own Play
Volunteers Played A Slot Machine Inside A Scanner
A Win Raised Activity In The Ventral Striatum
The Anterior Insula Responded To A Win As Well
One Cluster Appeared Near The Midbrain Dopamine Cells
Those Cells Are In The Substantia Nigra And Ventral Tegmental Area
A Near Miss Pays Nothing At All
The Ventral Striatum Responded Anyway
Right Anterior Insula Activity Rose With It
A Later Study Tested Patients With Brain Damage
One Set Of Patients Had Damage To The Insula
Those Patients Did Not Show The Near Miss Effect
A Roulette Task Tested The Gambler's Fallacy Too
Most Players Avoid A Color That Just Ran
The Same Patients Did Not Avoid It
Patients With Other Damage Still Showed Both
The Authors Called It The First Causal Evidence
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WHAT TREATMENT ACTUALLY DOES 🩺
Two Reviews Pooled The Trials
One Of Them Covered Psychological Therapy
Fourteen Studies Met Its Criteria
Those Trials Enrolled 1245 People
Eleven Compared Cognitive Behavior Therapy Against A Control
Benefits Showed Up Just After Treatment
Effects Ran From Medium To Very Large
Financial Loss Fell By A Medium Amount
Symptom Severity Fell By Much More
Only One Study Checked Again At Nine To Twelve Months
Its Effects Were Smaller And Not Significant
The Authors Wrote That Durability Is Unknown
A Second Review Covered Medication
Seventeen Studies Met That Bar
Those Studies Enrolled 1193 People
Antidepressants Did No Better Than Placebo
Opioid Antagonists Produced Short Term Improvement
Olanzapine Showed A Medium Benefit In Two Studies
The Support For Them Is Called Preliminary
Certainty For That Olanzapine Finding Was Rated Very Low
Longer Evaluation Periods Are Needed Before Firm Conclusions
