Neuropsychopharmacology Reviews | Published:

Sex differences in neural mechanisms mediating reward and addiction

Neuropsychopharmacologyvolume 44pages166183 (2019) | Download Citation


There is increasing evidence in humans and laboratory animals for biologically based sex differences in every phase of drug addiction: acute reinforcing effects, transition from occasional to compulsive use, withdrawal-associated negative affective states, craving, and relapse. There is also evidence that many qualitative aspects of the addiction phases do not differ significantly between males and females, but one sex may be more likely to exhibit a trait than the other, resulting in population differences. The conceptual framework of this review is to focus on hormonal, chromosomal, and epigenetic organizational and contingent, sex-dependent mechanisms of four neural systems that are known—primarily in males—to be key players in addiction: dopamine, mu-opioid receptors (MOR), kappa opioid receptors (KOR), and brain-derived neurotrophic factor (BDNF). We highlight data demonstrating sex differences in development, expression, and function of these neural systems as they relate—directly or indirectly—to processes of reward and addictive behavior, with a focus on psychostimulants and opioids. We identify gaps in knowledge about how these neural systems interact with sex to influence addictive behavior, emphasizing throughout that the impact of sex can be highly nuanced and male/female data should be reported regardless of the outcome.

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The work discussed in this review was funded in part by grants from the NIH: DA033526 and DA023094 (Chartoff), and NIH DA039952 (Becker).

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  1. Department of Psychology and the Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA

    • Jill B. Becker
  2. Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA

    • Elena Chartoff


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The authors declare that they have no competing interests.

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Correspondence to Elena Chartoff.

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