Impulse control disorders are psychological conditions characterized by the repeated inability to resist activities and behaviors that are harmful to oneself or others. Feelings of tension and anticipation precede the impulsive behavior, followed first by relief or a sense of gratification, and then by regret or guilt. Impulse control disorders may have neurological and environmental underpinnings and can be impacted by psychological, emotional and societal factors. According to the Thomson Gale Encyclopedia of Psychology, a link exists between control of impulses and serotonin, a brain chemical and neurotransmitter involved in depression and other mood disorders.
Citalopram
Some mental health practitioners consider impulse control disorders to be subgroups of other psychological conditions, such as anxiety, depression or obsessive-compulsive disorders. Stanford University conducted a study in which citalopram, a selective serotonin reuptake inhibitor or SSRI, was given to a group of compulsive shoppers. The results suggested that this drug may be able to curb uncontrollable shopping urges. In the study, patients with a diagnosed compulsive shopping disorder did not know if they were given citalopram or a placebo. In a paper published in the "Journal of Clinical Psychiatry," lead researcher and Stanford psychiatry professor, Dr. Lorrin Koran, M.D., reports that the majority of compulsive shoppers taking citalopram "rated themselves 'very much improved' or 'much improved' and reported a loss of interest in shopping."
Escitalopram
Escitalopram, another antidepressant, has shown some success in treating "impulsive-compulsive Internet usage disorder, an impulse-control disorder characterized by excessive time spent on the Internet at the expense of occupational, relationship, and social activities," according to a study by Bernardo Dell'Osso and his colleagues at Mount Sinai School of Medicine's Department of Psychiatry.
Fluoxetine
The connection between the neurotransmitter, serotonin and mood disorders, impulsivity and compulsivity has led researchers and mental health practitioners to investigate serotonin's involvement in causing or triggering trichotillomania, the compulsive pulling out of one's own hair. According to the article, "Understanding the Differences Between Impulsivity and Compulsivity," by Heather A. Berlin, Ph.D., MPH and Eric Hollander, M.D., both of the Department of Psychiatry, Mount Sinai School of Medicine, investigations of the use of SSRIs have yielded mixed results when it comes to treating trichotillomania.
Fluoxetine is one drug that has been studied as a treatment for both hair pulling and skin picking impulse control disorders. Although results seem promising for using fluoxetine to control skin picking, the results for trichotillomania have not been as successful.
Fluoxetine has also been investigated for use with people suffering from other impulse control disorders, such as pathological gambling and intermittent explosive disorder.
Clomipramine
Clomipramine, a tricyclic depression medication that has both antidepressant and anti-obsessional properties, is sometimes used to treat people with obsessive-compulsive disorder. Clomipramine works by increasing levels of serotonin, a natural substance in the brain that helps maintain mental balance, and it may be a beneficial medication for people with impulse control disorders. According to the publication, "Trichotillomania and its Treatment in Adults: A Guide for Clinicians," created by the Trichotillomania Learning Center, controlled studies have examined medications that may be useful for treating trichotillomania and other impulse control disorders. Clomipramine was the first medication shown to be effective, however, unpleasant side effects have limited its use with patients. Another antidepressant, venlafaxine, is well-tolerated and may be a better treatment choice.
References
- CBS Business Network: Impulse Control Disorders: Encyclopedia of Psychology
- Science Daily: Antidepressant Helps Alleviate Compulsive Shopping Disorder, Stanford Researchers Find
- National Center for Biotechnology Information: Escitalopram in the Treatment of Impulsive-compulsive Internet Usage Disorder
- UBM Medica Psychiatric Times: Understanding the Differences Between Impulsivity and Compulsivity
- Trichotillomania Learning Center: Pulling Hair: Trichotillomania and its Treatment in Adults: A Guide for Clinicians
