Treatment can suppress, but not cure aggression
Medications used to treat aggression and impulsive aggression include lithium, SSRIs, mood stabilizers, neuroleptics, and beta-blockers. However, the treatments are not a “magic bullet,” Dr. Coccaro noted. “The meds tend to suppress aggressiveness, but not cure it.”
Timing of treatment is also a factor for medication. In studies of patients taking lithium for aggression, for example, “when they gave the drug to people who liked being aggressive, they didn’t like being on these drugs because it made them feel unprotected. It just was at odds with who they thought they were,” Dr. Coccaro said. “The people who took the drug and did well and really liked being on the drug with people who didn’t like that they were aggressive.”
Neurorehabilitation and cognitive-behavioral therapy specific to aggression, called cognitive relaxation and coping skills therapy, are nonpsychotropic approaches to treating aggression. “These therapeutic approaches are working not only to reduce progression, but also to reduce the social information processing problems that aggressive individuals have,” Dr. Coccaro said.
Another approach, known as interpretation bias training, teaches individuals with aggression to judge slightly angry-looking photos of people as not being angry. After 7-14 days of training, aggressive behavior in adolescents has been shown to be reduced. The changes were also visible on functional MRI.
“What they found was that when you treated them, the change in the amygdala went down when you looked at the angry faces and in the left lateral, post training, they became happier,” Dr. Coccaro said.
Global Academy and this news organization are owned by the same parent company. Dr. Coccaro reported serving as a consultant for Avanir, Azevan, and Bracket. He also reported receiving research grants from the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, and the Pritzker Pucker Family Foundation.