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Compulsive Sexual Behavior Disorder / Pharmacotherapy / Internet Addiction Disorder · Journal article
Future Science Oa · June 8, 2026
Early or partial results. Treat as a signal, not a conclusion.
This systematic review identified 20 studies (1016 participants total) evaluating pharmacotherapies for online behavioral addictions, most targeting problematic gaming. Bupropion, SSRIs, and opioid receptor antagonists showed preliminary promise in reducing symptom severity, but the evidence base is constrained by small individual studies, paucity of RCTs, and short follow-up periods, precluding strong clinical recommendations.
Systematic review. Studies of pharmacotherapy for online behavioral addictions (problematic gaming, gambling, internet use, compulsive sexual behavior); most participants were adults and males.. Intervention: Pharmacotherapies including bupropion, selective serotonin reuptake inhibitors (SSRIs: escitalopram, fluoxetine, paroxetine, citalopram), and opioid receptor antagonists (naloxone and naltrexone); some studies combined pharmacotherapy with…. Compared with: Varied by study; comparators included standard care, psychotherapy alone, or placebo..
20 studies with 1016 participants reviewed; most targeted problematic online gaming, followed by gambling, internet use, and compulsive sexual behavior Bupropion, selective serotonin reuptake inhibitors (SSRIs: escitalopram, fluoxetine, paroxetine, citalopram), and opioid receptor antagonists (naloxone and naltrexone) were most frequently investigated These medications demonstrated potential in reducing symptom severity but evidence limited by methodological concerns
Combined treatment (psychotherapy + pharmacotherapy) was understudied
Clinicians should recognize that pharmacotherapy for online behavioral addictions lacks robust evidence at present. While bupropion, SSRIs, and opioid antagonists show preliminary signals, individual trial quality and size are limited; combined psychotherapy + pharmacotherapy may hold greater promise but remains understudied.
Systematic review of 20 small pharmacotherapy trials showing bupropion, SSRIs, and opioid antagonists with preliminary promise, but limited by few RCTs, small samples, and short follow-up, insufficient for practice-changing recommendations.
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Clinicians should recognize that pharmacotherapy for online behavioral addictions lacks robust evidence at present. While bupropion, SSRIs, and opioid antagonists show preliminary signals, individual trial quality and size are limited; combined psychotherapy + pharmacotherapy may hold greater promise but remains understudied.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Introduction. In response to the increasing prevalence of online behavioral addictions, researchers have investigated various treatment approaches, including pharmacotherapies. This systematic review aimed to summarize pharmacotherapeutic studies of online behavioral addictions.Methods. PubMed, MEDLINE, and Embase were searched to identify randomized controlled trials or quasi-experimental studies of pharmacotherapy for online behavioral addictions. Studies were excluded if they only targeted offline behavioral addictions. Study findings were summarized, and the Effective Public Health Practice Project Quality Assessment Tool was used for quality assessment.Results. This systematic review included 20 studies (1016 participants). Bupropion, selective serotonin reuptake inhibitors (SSRIs), and opioid receptor antagonists were most frequently studied and showed preliminary promise in reducing symptom severity. Many pharmacotherapeutic studies addressed co-occurring concerns, such as depression.Conclusions. Pharmacotherapies for online behavioral addictions appear promising, but the evidence base was limited by small samples, few randomized controlled trials, and short follow-up periods. Given preliminary support for psychotherapy + pharmacotherapy for problematic gaming, future research may evaluate the efficacy of combined treatment for a broader range of online behavioral addictions. Future research should also investigate pharmacotherapies for emerging problematic online behaviors, such as AI-based sexual engagement and problematic cryptocurrency trading.
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