Title:The Unity of Opposites: The Flux Between Impulsiveness and Compulsiveness Mediated by the Endocannabinoid System
Volume: 17
Issue: 3
Author(s): Oguz Tan*
Affiliation:
- Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul,Turkey
Keywords:
Compulsiveness, impulsiveness, addiction, endocannabinoid system, obsessive-compulsive disorder, impulse control disorders.
Abstract: Background: Impulsiveness and compulsiveness, though traditionally
assumed to represent the opposite poles of a spectrum, have increasingly been understood
to have common, rather than disparate, features.
Objective: We investigated the influence of the ECS on the intricate interplay between
impulsiveness and compulsiveness.
Methods: We conducted a search in PubMed, PsyhInfo, and Scopus by using the
keywords compulsiveness, Obsessive-Compulsive Disorder (OCD), impulsiveness,
Impulse Control Disorders (ICDs), addiction, ECS, serotonin, and dopamine.
Results: The ECS is famous for its role in motivational processes and reward signaling,
contributing to the hedonic effect elicited by pleasurable activities. Impulsiveness
involves an inability to delay pleasure; compulsiveness, in contrast, is associated
with a postponement of present pleasure due to an increased sense of menace.
Impulsiveness and compulsiveness work together to result in addiction.
The manipulation of the ECS through pharmacological or genetic methods is effective
on the manifestations of OCD, ICDs, and impulsiveness. The ECS is distributed
throughout the basal ganglia, prefrontal cortex, amygdala, and hippocampus
and interacts with serotonergic, dopaminergic, noradrenergic, GABAergic,
and glutamatergic neural circuits which are all involved in impulsive and compulsive
symptomatology. The ECS or cannabinoids exhibit divergent effects depending
on environmental conditions, dose, and duration of exposure. The endocannabinoids
are retrograde messengers inhibiting the presynaptic neurons (causing a
braking effect) and released “on demand”, generating a fine-tuning adjustment of
the neural activity.
Conclusion: How impulsiveness and compulsiveness, two apparently opposite
traits, interoperate might be accounted for by the specific functions of the ECS.
