![]() Gambling disorder and the dopaminergic reward system Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved. ![]() None of the bodies mentioned above had any role in or influence on the present research and this does not alter our adherence to PLOS ONE policies on sharing data and materials. Also, a clinical follow-up study has been planned in collaboration with the company Kontigo care, which provides follow-up devices free of charge for a clinical treatment trial in gambling disorder, but without any further financial support to the research group or its members. No direct fees or ompensations were paid to the individual sub-investigator. Håkansson also has been the national sub- nvestigator of a pharmaco-epidemiological survey, carried out by the independent research institute Triangle Research Institute, United States, and financed by the pharmaceutical company Shire. Anders Håkansson holds a position at Lund University which is supported by the stateowned Swedish gambling operator AB Svenska Spel as part of its responsible gambling policies, and also has research funding from the research councils of that body and from the research council of the Swedish alcohol monopoly, Systembolaget. ![]() ![]() Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Mirjam Wolfschlag declares no competing interests. ![]()
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