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. 2023 Aug 11;20(8):696–706. doi: 10.30773/pi.2022.0297

Table 1.

Summary of articles included for systematic review

Study Study design Participants GD measure Treatment Duration Improvement in IGD Symptoms (%) Key results
Bae et al. [9] (2018) Open clinical trial 16 male adults with internet gaming disorder (IGD; 25.3±5.2 yr), 15 male adults with internet-based gambling disorder (ibGD; 25.0±4.9 yr), 15 male adult healthy controls (25.7±4.7 yr) Young’s Internet Addiction Scale (YIAS) Bupropion 12 weeks IGD group: 20.5%; ibGD group: 4.7% • After 12 weeks of treatment, IGD and ibGD symptoms decreased in both treatment groups
• In IGD group, functional connectivity (FC) within the posterior default mode network (DMN) and between the DMN and cognitive control network (CCN) decreased following treatment
• In IGD group, FC within the DMN was positively correlated with changes in the YIAS after treatment
• In the ibGD group, FC within the posterior DMN decreased while FC within the CCN increased following treatment
Han and Renshaw [10] (2012) Prospective, randomized, controlled, double-blind clinical trial 57 male adults with excessive online game play and major depressive disorder (MDD); 29 treatment group (21.2±8.0 yr), 28 placebo group (19.1±6.2 yr) YIAS Bupropion 8 weeks 36.8% 8 weeks, 40.7% 12 weeks • YIAS scores and time playing online games were greatly reduced in bupropion group compared to placebo group
• Bupropion-associated reductions in online game play persisted during four-week post-treatment follow-up period
Han et al. [21] (2010) Open clinical trial 11 male adults with internet video game addiction (IA; 21.5±5.6 yr), 8 male adult healthy controls (20.3±4.1 yr) YIAS Bupropion sustained release (SR) 6 weeks 15.40% • After 6 weeks of bupropion SR, craving for internet video game play, total game play time, and cue-induced brain activity in the dorsolateral prefrontal cortex were decreased in the IA group
Kim et al. [19] (2012) Open clinical trial 65 male adolescents with excessive online game play and MDD; 32 CBT-Bupropion group (16.2±1.4 yr), 33 Bupropion group (15.9±1.6 yr) YIAS Cognitive behavioral therapy (CBT) combined with Bupropion (CBT-Bupropion group) or Bupropion alone (Bupropion-alone group) 8 weeks CBT-Bupropion group: 51.4% 8 weeks, 49.1% 12 weeks; Bupropion group: 33.6% 8 weeks, 33.3% 12 weeks • After 8 weeks, CBT-Bupropion group showed significantly greater decrease in YIAS scores and mean game playing time compared to Bupropion-alone group
• In both groups, changes in YIAS scores were positively correlated with changes in depression
• No changes in YIAS scores or total game playing time observed in either group during the 4-week post-treatment follow-up period
Nam et al. [26] (2017) Prospective, controlled, double-blind clinical trial 30 adults with IGD and MDD; 15 Bupropion group (22.9±1.9 yr), 15 Escitalopram group (23.9±1.6 yr) YIAS Bupropion SR or Escitalopram 12 weeks Not reported • IGD and MDD symptoms in both groupsimproved after 12 weeks of treatment
• After treatment, FC within only the DMN in escitalopram decreased, while FC between DMN and salience network decreased in bupropion SR group
• Compared to escitalopram, bupropion SR was associated with significantly decreased FC within the salience network and between the salience network and the DMN
Song et al. [8] (2016) Open clinical trial 119 male adolescents and adults with IGD; 44 Bupropion group (20.0±3.62 yr), 42 Escitalopram group (19.8±4.2 yr), 36 Observation group (19.6±4.0 yr) YIAS Bupropion SR or Escitalopram 6 weeks Bupropion group: 34.9%; Escitalopram group: 24.0% • After 6 weeks of treatment, both bupropion SR and escitalopram groups showed greater reductions in IGD symptoms compared to a control group who was observed in the community
• Bupropion group showed greater reductions in IGD symptoms compared to control group
Kim et al. [22] (2017) Open clinical trial 20 male adults with IGD (22.71±5.47 yr), 29 male adult healthy controls (23.97±4.36 yr) Young’s Internet Addiction Test (Y-IAT) Selective serotonin reuptake inhibitors: Escitalopram, Fluoxetine, or Paroxetine 6 weeks 21.50% • From pre- to post-treatment, the IGD group exhibited a significant decrease in IGD symptoms
• Compared to healthy controls, the IGD group displayed increased resting-state electroencephalography (EEG) activity in the delta and theta bands at baseline, which normalized following treatment
• Decreased resting-state EEG activity in delta and theta bands from pre- to post-treatment was associated with decreased IGD symptoms
• Higher absolute theta activity at baseline predicted greater improvement in IGD symptoms following treatment, controlling for depressive and anxiety symptoms
Lim et al. [23] (2016) Open clinical trial 44 young adult males with IGD (19.159±5.216 yr), 40 young adult male healthy controls (21.375±6.307 yr) Y-IAT Selective serotonin reuptake inhibitors (not specified) 6 months 18.7% • From pre- to post-treatment, the IGD group showed significant reductions in IGD severity, as well as increased quality of life, response inhibition, and executive functioning
• Low working memory functioning and high executive functioning at baseline predicted improvements in IGD symptoms among the IGD group from pre- to post-treatment
Park et al. [24] (2017) Open clinical trial 18 male adults with IGD (22.6±5.1 yr), 29 male adult healthy controls (24.7±3.8 yr) Y-IAT Selective serotonin reuptake inhibitors: Escitalopram, Fluoxetine, or Paroxetine 6 months 22.1% • At baseline, IGD group displayed significantly lower P300 amplitudes and delayed latencies at the midline centro-parietal site compared to healthy group
• Significant reduction in IGD symptoms observed following 6 months of treatment
• No significant changes in the P300 indices observed from pre- to post-treatment
• No significant difference in ERPs was observed between responders and non-responders to 6-month treatment
• Reduced P300 amplitudes and delayed latencies may be candidate endophenotypes in the pathophysiology of IGD
Park et al. [25] (2018) Open clinical trial 30 male adults with IGD (23.27±5.15 yr), 32 male adults healthy controls (24.97± 3.70 yr) Y-IAT Selective serotonin reuptake inhibitors: Escitalopram, Fluoxetine, or Paroxetine 6 months 17.6% • IGD group displayed increased beta and gamma intrahemispheric coherence and increased delta intrahemispheric coherence of the right hemisphere at baseline, compared to healthy controls
• IGD group displayed reduced IGD symptoms following treatment compared to baseline but continued to show increased beta and gamma intrahemispheric coherence compared to healthy controls
• IGD group did not display significant EEG coherence changes between the pre- and post-treatment assessments
Han et al. [20] (2009) Open, uncontrolled clinical trial 62 children (10 females) with ADHD who played internet video games (9.3±2.2 yr) Young’s Internet Addiction Scale–Korean version (YIAS-K) Methylphenidate (MPH) 8 weeks 23.70% • After 8 weeks of treatment, YIAS-K scores and internet usage times significantly reduced compared to baseline
• Changes in YIAS-K scores were associated with changes in inattention and visual attention
Park et al. [7] (2016) Prospective, randomized, controlled, single-blind clinical trial 84 male adolescents with ADHD and IGD; 44 MPH group (16.9±1.6 yr), 40 ATM group (17.1±1.0 yr) YIAS MPH or Atomoxetine (ATM) 12 weeks MPH group: 32.8%; ATM group: 19.0% • Both MPH and ATM reduced symptoms of IGD
• Changes in IGD symptoms were associated with changes in impulsivity
• No significant differences observed in IGD symptom or impulsivity reduction between MPH and ATM group

GD, gaming disorder; ERP, event-related potential; ADHD, attention deficit hyperactivity disorder