Fluoxetine in the treatment of anger: an open clinical trial.
BACKGROUND
Intense anger, easy irritability, and low frustration tolerance are frequently encountered in clinical practice and may occur as part of the constellation of symptoms associated with a number of Axis I and Axis II diagnoses. Recent studies have suggested the efficacy of fluoxetine in treating anger in depressed and borderline patients. The present study examines the treatment of anger as a target symptom regardless of accompanying psychopathology.


METHODS
In this preliminary trial, 11 subjects experiencing intense anger were treated in an open-label fashion with fluoxetine over an 8-week period. Anger was measured by a clinician-administered Clinical Global Impressions-Severity (CGI-S) scale and a self-report anger inventory, the Multidimensional Anger Inventory (MAI). The Hamilton Rating Scale for Depression was administered at baseline and final visits.


RESULTS
All 11 enrolled patients completed the study, and all patients demonstrated clinical improvement as measured by both the CGI-S and the MAI. Nine patients were rated as responders and 2 as nonresponders according to prospectively established criteria. Fluoxetine was well tolerated and showed rapid onset of action.


CONCLUSIONS
This study is limited by small sample size and nonblinded, open-label design, but nonetheless suggests that fluoxetine may be useful in moderating anger as it occurs as part of the symptomatology of a number of Axis I and Axis II disorders. Controlled studies are warranted.
Rubey
R N
RN
Department of Veterans Affairs, Charleston, SC 29401-5799, USA.
Johnson
M R
MR
Emmanuel
N
N
Lydiard
R B
RB
D000328:Adult; D000553:Ambulatory Care; D000786:Anger / Q000187:drug effects*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005473:Fluoxetine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005473:Fluoxetine