Pharmacologic approach to aggression in neuropsychiatric disorders.
Aggressive behavior has been associated with numerous neurologic conditions including traumatic brain injury, mental retardation, developmental disorders, Huntington disease, and several dementias. Preclinical and human studies suggest that dysfunction of neural systems involving the brainstem, hypothalamus, amygdala, or prefrontal cortex can give rise to aggression. Several neurochemicals are felt to be relevant to modulation of aggression, including serotonin, dopamine, norepinephrine, GABA, acetylcholine, and androgens. Pharmacologic intervention studies have targeted these systems but have been limited by inconsistent definitions of aggression and a relative paucity of controlled trials. This article briefly reviews studies of neural systems and medication trials relevant to aggression and propose a clinical approach to treatment of patients manifesting aggressive behavior.
Ryan
J M
JM
University of Rochester Medical Center, Monroe Community Hospital, Program in Neurobehavioral Therapeutics, 435 E. Henrietta Rd., Rochester, NY 14620, USA.
D000374:Aggression / Q000187:drug effects*; D001921:Brain / Q000378:metabolism / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D003663:Decision Trees; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D008032:Limbic System / Q000503:physiopathology; D009434:Neural Pathways / Q000503:physiopathology; D018377:Neurotransmitter Agents / Q000378:metabolism*; D017397:Prefrontal Cortex / Q000503:physiopathology
D002491:Central Nervous System Agents; D018377:Neurotransmitter Agents