Abstract | BACKGROUND: Evidence of an inverse relationship between central serotonergic ( serotonin [ 5-hydroxytryptamine]) system function and impulsive aggressive behavior has been accumulating for more than 2 decades. If so, pharmacological enhancement of serotonin activity should be expected to reduce impulsive aggressive behavior in subjects in whom this behavior is prominent. METHODS: A double-blind, placebo-controlled trial of the selective serotonin-uptake inhibitor fluoxetine hydrochloride was conducted in 40 nonmajor-depressed, nonbipolar or schizophrenic, DSM-III-R personality-disordered individuals with current histories of impulsive aggressive behavior and irritability. Measures included the Overt Aggression Scale-Modified for Outpatients, Clinical Global Impression Rating of Improvement, and several secondary measures of aggression, depression, and anxiety. RESULTS:
Fluoxetine, but not placebo, treatment resulted in a sustained reduction in scores on the Irritability and Aggression subscales of the Overt Aggression Scale-Modified for Outpatients that was first apparent during months 2 and 3 of treatment, respectively. Fluoxetine was superior to placebo in the proportion of "responders" on the Clinical Global Impression Rating of Improvement: first at the end of month 1, and then finally demonstrating a sustained drug-placebo difference from the end of month 2 through the end of month 3 of treatment. These results were not influenced by secondary measures of depression, anxiety, or alcohol use. CONCLUSION:
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Authors | E F Coccaro, R J Kavoussi |
Journal | Archives of general psychiatry
(Arch Gen Psychiatry)
Vol. 54
Issue 12
Pg. 1081-8
(Dec 1997)
ISSN: 0003-990X [Print] United States |
PMID | 9400343
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Placebos
- Fluoxetine
- Serotonin
- norfluoxetine
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Topics |
- Adult
- Aggression
(drug effects)
- Double-Blind Method
- Fluoxetine
(analogs & derivatives, blood, pharmacokinetics, therapeutic use)
- Humans
- Impulsive Behavior
(blood, drug therapy, physiopathology)
- Male
- Patient Dropouts
- Personality Disorders
(drug therapy, physiopathology, psychology)
- Placebos
- Psychiatric Status Rating Scales
- Serotonin
(physiology)
- Treatment Outcome
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