Impulsive Aggressive Behavior: Open-Label Treatment With Citalopram
J Clin Psychiatry 2003;64:81-85
© Copyright 2014 Physicians Postgraduate Press, Inc.
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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.
Method: 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).
Conclusion: These results suggest that
citalopram is an effective treatment for reducing impulsive