SSRI Therapy for Dementia With Aggression After Head Injury
SSRI Therapy for Dementia With Aggression After Head Injury
Head injury of any severity can result in acute and chronic neuropsychiatric symptoms. After head injury, aggressive behaviors can be disabling to victims and stressful to their families. When aggression is compounded by dementia, treatment can be more difficult. Psychotropic agents can attenuate aggressive behaviors associated with mental disorders. Three patients with dementia and chronic aggression after head injury responded favorably to selective serotonin reuptake inhibitors.
More than 2,000,000 people in the United States sustain head injuries annually, resulting in approximately 50,000 chronic disabilities. Even those with mild head injuries can suffer long-term sequelae, and virtually all who survive severe head trauma experience significant neuropsychiatric sequelae. Depression and aggressive behavior are not uncommon secondary conditions resulting from head injury; data on their frequencies after head injury differ greatly from one study to the next. Depressive and aggressive symptoms can be disabling to victims and stressful to their families.
Onset of aggression after head injury ranges from days to years after injury. Violence occurring immediately after injury often is associated with confusion, whereas aggression that appears later may manifest as a personality change or lowered threshold for irritability. Although no drug has been approved by the Food and Drug Administration specifically for treating aggressive behavior after head injury, pharmacotherapy is common in the management of patients with these symptoms. Agents that have been used to reduce aggression after head injury include antipsychotics, benzodiazepines, anticonvulsants, lithium, buspirone, propranolol, and antidepressants. We describe three patients with dementia and chronic aggression associated with head injury who responded favorably to selective serotonin reuptake inhibitors (SSRIs).
Head injury of any severity can result in acute and chronic neuropsychiatric symptoms. After head injury, aggressive behaviors can be disabling to victims and stressful to their families. When aggression is compounded by dementia, treatment can be more difficult. Psychotropic agents can attenuate aggressive behaviors associated with mental disorders. Three patients with dementia and chronic aggression after head injury responded favorably to selective serotonin reuptake inhibitors.
More than 2,000,000 people in the United States sustain head injuries annually, resulting in approximately 50,000 chronic disabilities. Even those with mild head injuries can suffer long-term sequelae, and virtually all who survive severe head trauma experience significant neuropsychiatric sequelae. Depression and aggressive behavior are not uncommon secondary conditions resulting from head injury; data on their frequencies after head injury differ greatly from one study to the next. Depressive and aggressive symptoms can be disabling to victims and stressful to their families.
Onset of aggression after head injury ranges from days to years after injury. Violence occurring immediately after injury often is associated with confusion, whereas aggression that appears later may manifest as a personality change or lowered threshold for irritability. Although no drug has been approved by the Food and Drug Administration specifically for treating aggressive behavior after head injury, pharmacotherapy is common in the management of patients with these symptoms. Agents that have been used to reduce aggression after head injury include antipsychotics, benzodiazepines, anticonvulsants, lithium, buspirone, propranolol, and antidepressants. We describe three patients with dementia and chronic aggression associated with head injury who responded favorably to selective serotonin reuptake inhibitors (SSRIs).
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