title: The psychopharmacology of aggressive behavior:  a translational approach: part 2:  clinical studies using atypical antipsychotics, anticonvulsants, and lithium.
abstract: Patients experiencing mental disorders are at an elevated risk for developing aggressive behavior. In the past 10 years, the psychopharmacological treatment of aggression has changed dramatically owing to the introduction of atypical antipsychotics on the market and the increased use of anticonvulsants and lithium in the treatment of aggressive patients.This review (second of 2 parts) uses a translational medicine approach to examine the neurobiology of aggression, discussing the major neurotransmitter systems implicated in its pathogenesis (serotonin, glutamate, norepinephrine, dopamine, and γ-aminobutyric acid) and the neuropharmacological rationale for using atypical antipsychotics, anticonvulsants, and lithium in the therapeutics of aggressive behavior. A critical review of all clinical trials using atypical antipsychotics (aripiprazole, clozapine, loxapine, olanzapine, quetiapine, risperidone, ziprasidone, and amisulpride), anticonvulsants (topiramate, valproate, lamotrigine, and gabapentin), and lithium are presented. Given the complex, multifaceted nature of aggression, a multifunctional combined therapy, targeting different receptors, seems to be the best strategy for treating aggressive behavior. This therapeutic strategy is supported by translational studies and a few human studies, even if additional randomized, double-blind, clinical trials are needed to confirm the clinical efficacy of this framework.
authors.affiliation: Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montreal, Canada.
authors.forename: Stefano
authors.initials: S
authors.lastname: Comai
authors.forename: Michael
authors.initials: M
authors.lastname: Tau
authors.forename: Zoran
authors.initials: Z
authors.lastname: Pavlovic
authors.forename: Gabriella
authors.initials: G
authors.lastname: Gobbi
mesh_terms: D000374:Aggression / Q000187:drug effects*; D000818:Animals; D000927:Anticonvulsants / Q000494:pharmacology*; D014150:Antipsychotic Agents / Q000494:pharmacology*; D006801:Humans; D018020:Lithium Compounds / Q000494:pharmacology; D001523:Mental Disorders / Q000188:drug therapy* / Q000503:physiopathology; D057170:Translational Research, Biomedical
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D018020:Lithium Compounds