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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by iforgotmypassword on October 3, 2005, at 16:26:58
what drugs are most helpful for someone that has extreme moments of being violent and angry? these outbursts come out of nowhere, but almost always have common subjects. i have broken a lot of things in my house and a few days ago i broke my cell phone. these anger outbursts seem to come in the place of feelings of sadness, loss, inertia, and frustration, and are projected out often in the form of blaming behaviour (though with some justification, the blaming tends to focus on *everyone* rather than what is relevant.)
i do believe that there were instances of my being treated very unfairly and that it has had a disastrous impact on my life, but my anger and violent emotions take over and i cannot express anything clearly and sensibly. it is not only putting a huge damper on my ability to express my emotions and my trouble, but it is deeply humiliating and scary.
do any meds help with this that aren't harmful to prefrontal cortex and executive/"initiative"/"external" functioning?
depressant side-effect possibility may be okay as my depression is probably best described as a pseudodepression.
Posted by Phillipa on October 3, 2005, at 18:44:14
In reply to medications for violence/anger, posted by iforgotmypassword on October 3, 2005, at 16:26:58
What is pseudodepression? It sounds like it's not real. And when I get really frustrated when someone doesn't listen to me I've smashed things. Fondly, Phillipa
Posted by lunesta on October 3, 2005, at 19:04:58
In reply to Re: medications for violence/anger » iforgotmypassword, posted by Phillipa on October 3, 2005, at 18:44:14
Sinequan (doxepin) is good for anger/rage etc. It is very good for this.
Posted by med_empowered on October 3, 2005, at 19:47:08
In reply to Re: medications for violence/anger, posted by lunesta on October 3, 2005, at 19:04:58
common practice is to medicate hostile, agitated bipolars and agitated depressives with the more hardcore mood-stabilizers...depakote, lithium, tegretol. The idea is to cool them off, i suppose...although benzos can cause problems, a little bit of ativan or klonopin can also be useful, at least for some people. Propranolol, in higher-end doses, can be useful...it can induce depression, though. And, of course, there are the neuroleptics...the old and new ones can reduce hostility and aggression, but they basically do so by shutting down the patient's entire emotional system (Thorazine was called a "chemical lobotomy," after all). My advice would be to first try therapy to deal with this stuff...if that fails, maybe an as-needed benzo. Anything harsher should be reserved for a last-ditch effort at self-control.
Posted by SLS on October 4, 2005, at 9:57:21
In reply to medications for violence/anger, posted by iforgotmypassword on October 3, 2005, at 16:26:58
Many doctors like using Tegretol. It has a good track record. It tends to aid with impulse control and prevent behavioral dyscontrol, factors that might be contributing to violent outbursts. Some doctors are now experimenting with Trileptal, hoping that this cousin drug of Tegretol will work just as well but without the side effects of Tegretol.
Another strategy is to use Zoloft.
Borderline personality disorder (BPD) often includes as symptoms brief episodes of anger and rage. Some doctors have demonstrated a positive effect using Zyprexa in combination with Tegretol or Trileptal.
Sometimes the worst thing you can do with aggression or anger disorders is to use a benzodiazepine (BZD) or alcohol to "relax" them. There are instances where both of these produce an exaggerated anger or rage episode by producing something known as behavioral disinhibition.
- Scott
Posted by verne on October 4, 2005, at 22:19:27
In reply to Re: medications for violence/anger » iforgotmypassword, posted by SLS on October 4, 2005, at 9:57:21
I have borderline personality disorder and used to fly into rages (I'm much mellower now). Later I realized benzos seemed to contribute to these rages.
I wouldn't hurt anyone, just yell and hit or throw things. My yelling was so loud it was like I went into a supernatural trance. I could yell nonstop for several minutes without seeming to take a breath. (maybe I was really chanting or just channeling the odd, angry, ancient warlord)
The drug of choice for "rage" back then at the VA hospital was Propranolol or Inderal. I don't know what the dose was but it really had an immediate "cooling" effect. I felt as though my brain was being refrigerated.
I haven't taken a benzo in ten years and am currently on inderal LA 60 mgs per day. It helps with my anxiety but it might have a depressant effect.
There's a real qualitative difference between the Inderal LA and the conventional propranolol. The LA is very subtle and smooth whereas the regular inderal is a bit of a jolt to the system. I hate it when I have to realign and reorganize a jolted system.
Verne
Posted by Sebastian on October 8, 2005, at 15:14:26
In reply to medications for violence/anger, posted by iforgotmypassword on October 3, 2005, at 16:26:58
The only drug that works well for anger in me is pot. I took it for a while and all my anger is resolving. Now I am off the pot and still feel good. If pot is out of the question take zyprexa.
Posted by Declan on October 12, 2005, at 15:49:31
In reply to Re: medications for violence/anger, posted by Sebastian on October 8, 2005, at 15:14:26
I can't feel angry on pot either. It might turn anger into anxiety.
Declan
This is the end of the thread.
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