Impulse control disorders: Clinical characteristics and pharmacological management

ICDs have received relatively little attention from clinicians and researchers. Despite a prevalence similar to or greater than that for schizophrenia and bipolar disorder, much less research has been undertaken. Nevertheless, the treatment data presented in this article represent significant advances from only several years ago. With few published studies that even approximate large, well-powered controlled trials, it is not possible to make treatment recommendations with a substantial degree of confidence. No drugs are currently FDA-approved for the treatment of any of the formal ICDs. Specific drug therapies offer promise for the effective treatment of PG, although PG studies are substantially limited. Most published studies have employed relatively small sample sizes, are of limited duration, and involve potentially nonrepresentative clinical groups (eg, those without co-occurring psychiatric disorders). Heterogeneity of treatment samples may also complicate identification of effective treatments. At present, questions such as which medication to use and for whom, or the optimal duration of pharmacotherapy cannot be sufficiently addressed with the available data. For other ICDs, there are less available data to generate empirically supported treatment recommendations. In conjunction with emerging epidemiological data supporting a relatively high prevalence of ICDs, the small amount of empirical data on effective treatments for ICDs highlights the clinical need for additional research. Definitive pharmacological treatment recommendations await completion of large-scale, controlled treatment studies for these disorders and comparative investigations of pharmacological agents. Advances in these areas hold the potential for significantly improving the lives of individuals with ICDs and those directly or indirectly affected by their conditions.