Anger Drug Study

March 19, 2006 Anger is an emotion experienced by everyone at some point in time. Its a natural response to situations that are perceived as threatening. A certain amount of anger is healthy, because the feelings allow us to respond to a threat. As the body prepares to respond, heart rate and blood pressure increase. When anger gets out of control, it can lead to destructive behaviors. An angry person can verbally lash out at family members, coworkers - even strangers. Sometimes anger leads to physical aggression. Researchers estimate about 10 percent of anger episodes result in verbal or physical confrontation. Anger also takes a toll on the body. Some research suggests a link between anger and high blood pressure, heart disease, stroke and increased risk of death. In a recent study in the Annals of Family Medicine, researchers report anger appears to increase the risk of injury by up to eight times. Risk for injury was especially high in men. Anger Drug Study Currently, there arent any drugs specifically approved for treatment of anger. Recently, Jeffrey Mattes, M.D., Psychiatrist, studied use of a drug for patients having impulsive aggression or "bad tempers." The drug, called TRILEPTAL®, is currently approved to control partial seizures in patients with epilepsy. A seizure is caused by a burst of abnormal electrical activity in the brain. For patients with epilepsy, TRILEPTAL helps by reducing the excitability of nerve cells. In people who have problems controlling their temper that same process may help reduce excitability in the part of the brain dealing with anger emotions. In the study, 48 patients were given TRILEPTAL or a placebo. Mattes found those taking the drug experienced a reduction in their temper compared to those taking the placebo. In fact, some participants reported feeling much "calmer" while on the drug. Mattes says it takes a while to find the right dose of the drug to use for a patient. Doctors need to start with the lowest dose and then gradually increase the dosage until an effect is seen. Once the right dose level is found, patients show improved behavioral symptoms rather quickly. Mattes hopes to soon start a trial of another anti-seizure medicine to find out if it may also work for anger problems. He says medication may be best used in combination with psychological approaches, like counseling and anger management training. AUDIENCE INQUIRY For information about anger and some anger management tips: American Psychological Association, public website, http://www.apahelpcenter.org For information about TRILEPTAL®, http://www.trileptal.com/index.jsp BIBLIOGRAPHY Abe, S., and O. Takagi, "Relation of the Tendency to Feel Anger and Postanger Reappraisals," Psychological Reports, June 2005, Vol. 96, No. 3, Pt. 2, pp. 971-976. Carrere, Sybil, et al., "Anger Dysregulation, Depressive Symptoms, and Health in Married Women and Men," Nursing Research, May/June 2005, Vol. 54, No. 3, pp. 184-192. "Controlling Anger - Before It Controls You," Washington, DC: American Psychological Association, downloaded from public website (http://www.apahelpcenter.org), February 15, 2006. Dittman, Melissa, "Anger Across the Gender Divide," APA Monitor, March 2003, Vol. 34, No. 3, p. 52. Hollinworth, H., et al., "Understanding the Arousal of Anger," Nursing Standard, May 25, 2005, Vol. 19, No. 37, pp. 41-47. "Hostility Associated with Immune Function," APA Monitor, March 2003, Vol. 34, No. 3, p. 47. Koh, Kyung Bong, M.D., Ph.D., et al., "The Relation Between Anger Expression, Depression, and Somatic Symptoms in Depressive Disorders and Somatoform Disorders," Journal of Clinical Psychiatry, April 2005, Vol. 66, No. 4, pp. 485-491. Mattes, Jeffrey, M.D., "Oxcarbazepine in Patients with Impulsive Aggression," Journal of Clinical Psychopharmacology, December 2005, Vol. 25, No. 6, pp. 575-579. Nickel, Marius, M.D., et al., "Anger, Interpersonal Relationships, and Health-related Quality of Life in Bullying Boys Who Are Treated with Outpatient Family Therapy," Pediatrics, August 2005, Vol. 116, No. 2, pp. e247-e254. Shackman, J., and S. Pollak, "Experiential Influences on Multimodal Perception of Emotion," Child Development, September-October 2005, Vol. 76, No. 5, pp. 1116-1126. Smith, Deborah, "Angry Thoughts, At-Risk Hearts," APA Monitor, March 2003, Vol. 34, No. 3, p. 46. "Strategies for Controlling Your Anger," Washington, DC: American Psychological Association, downloaded from public website (http://www.apahelpcenter.org), February 15, 2006. Vinson, Daniel, M.D., et al., "State Anger and the Risk of Injury," Annals of Family Medicine, January-February 2006, Vol. 4, No. 1, pp. 63-68. Wattanakit, K., et al., "Association of Anger Proneness, Depression and Low Social Support with Peripheral Arterial Disease," Vascular Medicine, August 2005, Vol. 10, No. 3, pp. 199-206. Wenzel, A., and C. Lystad, "Interpretation Biases in Angry and Anxious Individuals," Behavior Research and Therapy, August 2005, Vol. 43, No. 8, pp. 1045-1054. Research compiled and edited by Barbara J. Fister