Pharmacological Modulation of Temporal Discounting: A Systematic Review

• Published in: Healthcare (Basel) 2023-04, Vol.11 (7), p.1046
• Main Authors: Sarmiento, Luis Felipe, Ríos-Flórez, Jorge Alexander, Paez-Ardila, Hector Andres, Lima de Sousa, Pêssi Socorro, Olivera-La Rosa, Antonio, Oliveira da Silva, Anderson Manoel Herculano, Gouveia, Jr, Amauri
• Format: Article
• Language: English
• Subjects: Addictions; Addictive behaviors; Amphetamines; Analysis; Bias; Decision making; Discount rates; drug administration; Drug therapy; Health aspects; Impulse; impulsivity; intertemporal decisions; Intervention; Mental illness; Methods; Patient outcomes; Personality disorders; Review; Self-control; Systematic review; temporal discounting; Testosterone; Text analysis
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare11071046

Temporal discounting is a phenomenon where a reward loses its value as a function of time (e.g., a reward is more valuable immediately than when it delays in time). This is a type of intertemporal decision-making that has an association with impulsivity and self-control. Many pathologies exhibit higher discounting rates, meaning they discount more the values of rewards, such as addictive behaviors, bipolar disorder, attention-deficit/hyperactivity disorders, social anxiety disorders, and major depressive disorder, among others; thus, many studies look for the mechanism and neuromodulators of these decisions. This systematic review aims to investigate the association between pharmacological administration and changes in temporal discounting. A search was conducted in PubMed, Scopus, Web of Science, Science Direct and Cochrane. We used the PICO strategy: healthy humans (P-Participants) that received a pharmacological administration (I-Intervention) and the absence of a pharmacological administration or placebo (C-Comparison) to analyze the relationship between the pharmacological administration and the temporal discounting (O-outcome). Nineteen studies fulfilled the inclusion criteria. The most important findings were the involvement of dopamine modulation in a U-shape for choosing the delayed outcome (metoclopradime, haloperidol, and amisulpride). Furthermore, administration of tolcapone and high doses of d-amphetamine produced a preference for the delayed option. There was a time-dependent hydrocortisone effect in the preference for the immediate reward. Thus, it can be concluded that dopamine is a crucial modulator for temporal discounting, especially the D2 receptor, and cortisol also has an important time-dependent role in this type of decision. One of the limitations of this systematic review is the heterogeneity of the drugs used to assess the effect of temporal discounting.