Impulsive aggressive behavior: open-label treatment with citalopram.
BACKGROUND
Results from open-label and placebo-controlled trials suggest that the selective serotonin reuptake inhibitors reduce impulsive aggressive behavior. The objective of this open-label study was to investigate whether citalopram treatment has anti-aggressive effect on impulsive aggressive subjects meeting DSM-IV criteria for a cluster B personality disorder or intermittent explosive disorder.


METHODS
In this 8-week trial, subjects were initiated on 20 mg/day of citalopram and titrated up to 60 mg/day by the fourth week, if tolerated. The primary outcome measure was the Overt Aggression Scale-Modified (OAS-M), a scale used to quantify verbal and physical aggression, subjective irritability, and overt irritability. Secondary outcome measures included the Barratt Impulsiveness Scale and Buss-Durkee Hostility Inventory.


RESULTS
Of 25 subjects enrolled, 20 completed the study. The mean daily dose was 45.5 mg, and citalopram was generally well tolerated. Statistically significant decreases were found in the OAS-M aggression scores (32.82 +/- 19.76 to 4.73 +/- 7.57, p =.000), subjective irritability scores (3.50 +/- 0.60 to 1.45 +/- 1.18, p =.000), and overt irritability scores (3.23 +/- 0.81 to 0.91 +/- 1.02, p =.000).


CONCLUSIONS
These results suggest that citalopram is an effective treatment for reducing impulsive aggressive behavior.
Reist
Christopher
C
Mental Health Care Group, VA Long Beach Healthcare System and Department of Psychiatry and Human Behavior, University of California, Irvine, USA. creist@uci.edu
Nakamura
Katsura
K
Sagart
Elahe
E
Sokolski
Kenneth N
KN
Fujimoto
Ken A
KA
D000328:Adult; D000374:Aggression / Q000187:drug effects* / Q000523:psychology; D015283:Citalopram / Q000627:therapeutic use*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors