Neuroreceptor Mechanisms of Aggression and Its Treatment

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Aggression results from the interaction of multiple systems. It can be classified as predatory, impulsive, or based on a medical condition. The likelihood of aggression is increased by environmental overstimulation or stress, transmitter balances favoring dopamine and excitatory amino acid transmission over serotonin and γ-aminobutyric acid transmission, and the presence of problems related to impulsivity. Treatments for aggression are based on the underlying causes and generally should combine pharmacologic and environmental or psychotherapeutic measures. Useful pharmacologic agents include mood stabilizers and atypical antipsychotics that combine dopaminergic and serotonergic actions. Drugs acting on nicotine receptors may deserve further attention. Nonpharmacologic measures include behavioral techniques aimed at reducing impulsivity, relapse prevention techniques for substance abuse, and anger management techniques.

J Clin Psychiatry 2003;64(suppl 4):26-35