A double-blind placebo-controlled crossover study of phenytoin in individuals with impulsive aggression

Stanford, Matthew S.; Houston, Rebecca J.; Mathias, Charles W.; Greve, Kevin W.; Villemarette-Pittman, Nicole R.; Adams, Donald K.

doi:10.1016/s0165-1781(01)00287-6

Cited by 69 publications

(79 citation statements)

References 18 publications

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“…Determining which pharmacological agents modify excessive patterns of maladaptive behaviors exhibited by individuals with CD is a part of the practice of clinical psychiatry and an active area of current research. A growing body of data supports the use of anticonvulsants for the management of agitation and aggressive behavior in clinical settings (Miller 2001;Stanford et al 2001;Afaq et al 2002;Frankenburg and Zanarini 2002;Sival et al 2002). Most frequent diagnosis recorded includes dementia, organic brain syndromes, mental retardation, personality disorders (i.e.…”

Section: Discussionmentioning

confidence: 99%

Acute effects of gabapentin on laboratory measures of aggressive and escape responses of adult parolees with and without a history of conduct disorder

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Acute effects of gabapentin on laboratory measures of aggressive and escape responses of adult parolees with and without a history of conduct disorder

et al. 2004

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“…In controlled studies, carbamezepine has been reported to be effective in patients with schizophrenia (Neppe 1988) and patients with dementia (Tariot et al 1998) but not in children (Cueva et al 1996). Phenytoin decreased aggressive outbursts in prisoners with a history of impulsive aggression (Barratt et al 1997a) and men with either obsessive-compulsive, anti-social or narcissistic personality disorders (Stanford et al 2001). Anticonvulsants may provide alternatives to serotonergic and dopaminergic pharmacotherapies but they need to be evaluated by additional controlled studies with larger numbers of subjects focusing on specific types of aggression.…”

Section: Pharmacological Manipulation Of Gabamentioning

confidence: 99%

Social and neural determinants of aggressive behavior: pharmacotherapeutic targets at serotonin, dopamine and ?-aminobutyric acid systems

et al. 2002

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(1) The preclinical focus on the behavioral characteristics and determinants of intense aggression promises to be most relevant to the clinical distinction between the proposed impulsive-reactive-hostile-affective subtypes of human aggression and the controlled-proactive-instrumental-predatory subtypes of aggression. The neural circuits for many types of human and animal aggression critically involve serotonin, dopamine and gamma-aminobutyric acid (GABA) and specific receptor subtypes. (2) The dynamic changes in frontal cortical serotonin that are triggered by engaging in aggressive behavior imply that serotonergic drug effects are largely determined by the functional state of the receptors at the time of drug treatment. Of the numerous 5-HT receptors currently identified, the 5-HT(1B) receptors offer a promising target for reducing impulsive aggressive behavior, particularly if the action can be limited to sites in the central nervous system. (3) Aggressive confrontations are salient stressors, both for the aggressor as well as the victim of aggression, that are accompanied by activation of the mesocorticolimbic but not the striatal dopamine system. Dopaminergic manipulations, particularly targeting the D(2) receptor family, can influence aggressive behavior in animals and human patients, suggesting that mesocorticolimbic dopamine may have important enabling or permissive functions. (4) GABA is critical in the neurochemical control of aggressive behavior as evidenced by studies that directly modify GABAergic neurotransmission and neurochemical studies that correlate GABA measurements with aggressive behavioral responses in several animal species. The GABA(A) receptor complex is a mechanism through which certain benzodiazepines and alcohol enhance and inhibit aggressive behaviors. Social and pharmacological experiences decisively determine the effects of GABAergic positive modulators on aggression.

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“…Early RCTs of the effects of lithium in reducing incidences of aggression of incarcerated offenders with antisocial personality disorder in the US proved promising and are reported elsewhere (Sheard, 1971;Sheard, Marini, & Wagner, 1976). Phenytoin has also been studied to good effect, within RCTs, in significantly reducing impulsive aggression in incarcerated offenders with antisocial personality disorder in the US; these results are reported elsewhere (Barratt et al, 1997;Stanford, 2001). Sanislow and McGlashan (1998), in a systematic review of treatment outcome literature, also report on the advantages of anticonvulsant use with borderline personality disorder symptoms and behaviours and with neuroleptics in schizotypal personality disorder in targeting low level psychotic symptoms.…”

Section: Pharmacological Treatmentmentioning

confidence: 98%

Personality Disorder Prevalence and Treatment Outcomes: A Literature Review

Lamont¹,

Brunero²

2009

Issues in Mental Health Nursing

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Personality disorder is argued to be the most prevalent psychiatric disorder and is considered to be a significant public health burden, yet there is little evidence that the disorder occupies a commensurate place in public health service planning, appropriate to such a burden. This paper reviews the prevalence and treatment outcome studies of individuals with personality disorder. The literature search highlighted prevalence studies and evidence based pharmacological, psychosocial, and alliance based interventions within this area. From this review, the place of mental health nurses within health service models is discussed.

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A double-blind placebo-controlled crossover study of phenytoin in individuals with impulsive aggression

Cited by 69 publications

References 18 publications

Acute effects of gabapentin on laboratory measures of aggressive and escape responses of adult parolees with and without a history of conduct disorder

Acute effects of gabapentin on laboratory measures of aggressive and escape responses of adult parolees with and without a history of conduct disorder

Social and neural determinants of aggressive behavior: pharmacotherapeutic targets at serotonin, dopamine and ?-aminobutyric acid systems

Personality Disorder Prevalence and Treatment Outcomes: A Literature Review

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