Prozac for violent behavior?

[Merely]

Anyone hear anything about high dose Prozac being used for anger/behavioral problems? My attending brought it up today but I didn’t really see anything about it online. Thanks

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[whopper]

I wouldn't use it for immediate agitation. If anything it could make it worse. It's not indicated for anger though could possible help with Intermittent Explosive Disorder but it has (but no med does) no indication for it.

 

[abcxyz0123]

There is evidence that SSRIs can reduce aggression

 

[Doc1401]

Anyone hear anything about high dose Prozac being used for anger/behavioral problems? My attending brought it up today but I didn’t really see anything about it online. Thanks

SSRIs have literature to support benefit in impulse control problems

Anyone hear anything about high dose Prozac being used for anger/behavioral problems? My attending brought it up today but I didn’t really see anything about it online. Thanks

In many cases SSRIs can be effective for impulse control issues, which can apply to anger. Anger itself may be a result of depression. There is a subpopulation of patients that develop SSRI activation, which may actually induce violence. Based on conversations I have had with other providers, paxil seems to stand out as one of the SSRIs that can induce such activation.

 

[smalltownpsych]

I would suggest staying away from the trap of trying to use medications to modify behavior. I don't see a link between depression and violence although sometimes patients who are violent complain about the legal and social problems that result from their behavior and say they are depressed. The big link between violence and medication is with abusable substances so I tend to emphasize the importance of treatment for substance use first and foremost.

 

[Attending1985]

I don’t know about high dose but people come to me all the time with what seems to be mostly personality stuff who are already on SSRIs and they say it helps with irritability and impulsive anger

 

[PistolPete]

In kids, Prozac is very helpful for irritability and depression, and is well known to reduce aggression in that sense. The problem is SSRI activation as noted above that can sometimes induce aggression. So basically, it depends on the patient! Sorry, no easy answer here.