ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Violence is a symptom of an underlying mental state such as a psychosis, a characterological problem, or brain dysfunction. Thus drugs used to treat aggression in man exert effects by their specific pharmacological actions (e.g., antipsychotic, anticonvulsant). Most literature to date has dealt with animals and human models of aggression and lacks conceptual clarity. Aggression differs from depression, a coherent clinical entity, in its etiological diversity and its paroxysmal or impulsive basis, and this may account for the relationship seen in literature linking violence to epilepsy; yet literature on anticonvulsants is equivocal with regard to beneficial effects on aggression. Lithium has been shown to have positive effects, although its mode of action is unclear. A variety of antipsychotic agents and minor tranquilizers have been mentioned. Central nervous system stimulants have been found useful to treat hyperkinetic syndromes in both children and adults where aggression is a symptom. Hormonal agents are discussed. Drug treatment of aggression should not obscure the need for verbal therapies, and social and environmental factors should always be regarded.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Most of the drugs used in the treatment of aggressive syndromes have originally been developed for other clinical applications. Despite significant differences in the pathogenesis of various aggressive disorders, the frequently used “antiaggression” drugs are the major tranquilizers (neuroleptics). If the aggression is associated with psychosis, chlorpromazine or haloperidol are the drugs of choice. Aggressive disorders within the acute and chronic brain syndromes are best treated with pericyazine, thioridazine, and thiothixene. In aggressive symptoms of mentally retarded patients, particularly with epileptic syndromes, a new benzazepine (SCH-12,679) was found to be very effective. Aggression associated with alcoholism or narcotic addiction showed best response to chlorpromazine and haloperidol. As a general rule, in aggressive patients with clinically known epilepsy, or with abnormal electroencephalographic findings, the major tranquilizers with potent sedative properties should be given with great caution.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Clinical trials designed to evaluate the efficacy of drugs in human aggression have been scarce until recent years. The potential antiaggressive action of minor tranquilizers in humans has received little attention in spite of the claimed “taming effect” in some animal studies. A recent report examining the literature regarding the effects of benzodiazepines on animal models of aggressive behavior has pointed out the lack of consistency in such findings. Similar observations have been noted in humans where reduction in aggressive manifestations is contrasted with an increase in hostility in a few studies, as well as with the appearance of “paradoxical” rage reactions. Some variables that could account for such discrepancies have been advanced. They include, among others, dosage, acutevs.chronic drug administration, and possible qualitative differences among this group of agents. Individual variations as to presenting clinical picture, initial levels of anxiety and hostility, and personality types have also been mentioned. Implications of some of these findings for future clinical research are discussed.At present, a study designed to test the efficacy of two benzodiazepines, at dosages higher than those usually recommended, is being carried out in a population of anxious, aggressive-prone individuals with poor impulse control. Thus far, and in agreement with our previous clinical experience, we have not seen “paradoxical” rage and such high dosages have been well tolerated.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Lithium has become a widely accepted treatment for manic-depressive psychosis. It is dramatically effective for many cases of mania and is useful in the prevention of manic and depressive episodes. Hyperaggressivertess and hypersexuality are frequent components of manic-depressive illness and abate under the influence of lithium. A brief review is presented of the behavioral and biochemical pharmacology of lithium. This documents the inhibitory role which lithium can play in several examples of animal aggressive behavior including pain-elicited aggression, mouse killing in rats, isolation-induced aggression in mice,p-chlorophenylalanine-induced aggression in rats, and hypothalamically induced aggression in cats. The use of lithium to control human aggressive behavior has resulted in controversial findings. In epileptic conditions, improvement has been reported in interseizure aggressivity, but other reports indicate the possibility of increased seizures. Improvement in aggressive behavior in childhood has occasionally been reported as well as in emotionally unstable character disorders in young female patients. Two studies are described in male prisoners with a major problem of hyperaggressiveness; one was a single blind study and the other a large but uncontrolled study. Both studies reported an improvement in aggressiveness as indicated by fewer recorded reports (tickets) for fighting. The final study reported is a study of 12 male delinquents age 16 to 23. They received lithium or placebo for 4 months inside an institution and then a trial of lithium for 1 to 12 months on an outpatient basis. Analysis of results in terms of the number of aggressive antisocial acts showed fewer serious aggressive episodes when the lithium level was between 0.6 and 1 meq/liter than when it was between 0.0 and 0.6 meq/liter. These results must be viewed with caution and are only suggestive since the study was not double blind.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A significant number of violent acts are committed by individuals in whom central nervous system instability can be demonstrated by special electroencephalographic (EEG) activation procedures utilizing α-chloralose as the activating agent. Furthermore, subcortical electrograms suggest that this instability is related to a circumscribed ictal phenomenon in the limbic system. The abruptness of the aggressive act, the fact that the behavior is so often out of character for the individual and inappropriate for the situation, as well as the confusion and partial amnesia which accompany these episodes lend clinical support for the ictal hypothesis. Some anticonvulsants not only block the activated abnormalities on the EEG but also lead to dramatic clinical improvement in those individuals showing repeated and frequent aggressive behavior. For instance, in one study 46.7 per cent and 53.3 per cent of the patients demonstrated activated abnormalities on no drug and placebo, respectively. When these same patients were receiving chlorpromazine or trifluoperazine, the activation rates were 60.0 per cent and 73.3 per cent, respectively. On the other hand, when these same patients were placd on a regimen of chlordiazepoxide the activation rate was reduced to 20 per cent (p< .01).Another study involved severely disturbed chronically hospitalized psychotic patients whose aggressive uncontrolled outbursts relegated them not only to a locked ward, but often to isolation rooms despite high doses of phenothiazines. A regimen of chlordiazepoxide and/or primidone added to their current medication led to dramatic improvement in 23 patients and some improvement in 17 others. Only 15 subjects showed no response to this regimen.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Evidence for the role of androgens in the male aggressive and sexual behavior is reviewed. Medroxyprogesterone acetate (MPA; Provera, Upjohn) has a marked antiandrogen property; it is effective in lowering the testosterone level and controlling certain otherwise intractable sex deviations. The finding in 6 patients treated for sex deviation are summarized. The effects of MPA in the treatment of 11 temporal lobe epileptics and 5 other patients with severe angry-aggressive behavior disorder are reported. Most temporal lobe epileptics responded well to MPA. Weight gain and earlier sleep were consistent side effects. The values of plasma testosterone, serum luteinizing hormone, and urinary 17-ketosteroids were decreased by the treatment. Four patients were XYY individuals with lack of control over their sexual-aggressive or angry-aggressive impulses.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A review of the literature on the relation between psychostimulants drugs and aggression leads to the following conclusions.1) In laboratory animals, small and moderate acute doses of the major stimulants (as dextroamphetamine) generally either reduce or have no effect on aggression, whereas high doses and chronic moderate to high doses of these drugs increase aggression in most species.2) In man, aggression is not produced by the major Federal Drug Administration licensed psychostinmlants, except in doses which produce a paranoid psychosis. Such doses are customarily, although not uniformly, high. The drug-intoxicated person's aggression then is characteristically a defensive response to frightening delusions.3) Children with hyperactivity and aggressive behavior usually respond to stimulant medication with reduced fighting, defiance, and impulsiveness. The effect of the drug on aggression may be separate from its effect on hyperactivity.4) Hyperactive, aggressive adolescents respond to stimulants with the same benefits as do hyperactive children.The available data on the human response to stimulants suggest a need to better evaluate low dose amphetamine effects on aggression in adolescents and adults.

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1975

数据来源: OVID