Internet Sex Addiction Treated With Naltrexone

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Internet Sex Addiction Treated With Naltrexone J. Michael Bostwick, MD, Jeffrey A. Bucci, MD Mayo Clinic Proceedings Volume 83, Issue 2, Pages 226-230 (February 2008) DOI: 10.4065/83.2.226 Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE In the cross-sectional image of the brain, incentive salience circuitry (ISC) consists of the ventral tegmental area (VTA) projecting to the nucleus accumbens (NAc). The NAc receives modulatory input from the prefrontal cortex (PFC), amygdala (A), and hippocampus (HC). Box A portrays Internet pornography causing the release of endogenous opioids that enhance dopamine (DA) release in the ISC both directly and indirectly.2 Opiates increase DA action directly through guanine nucleotide-binding protein-coupled opioid receptors on the NAc. They work indirectly on interneurons by binding to opioid receptors that interfere with release of ×-aminobutyric acid (GABA). No longer suppressed by GABA, the VTA sends the NAc an outpouring of DA. Pornography's salience increases. Box B shows how naltrexone blocks both NAc and interneuron opioid receptors. The DA incentive is no longer enhanced, either directly or indirectly, resulting in pornography's decreased salience. Adapted by permission from Macmillan Publishers Ltd: Nature Neuroscience,2 copyright 2005. Mayo Clinic Proceedings 2008 83, 226-230DOI: (10.4065/83.2.226) Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions