References:
- Course Module
IED is characterized by repeated episodes of impulsive, aggressive, violent behavior, and angry verbal outbursts, often lasting less than 30 minutes. Physical injury to the self and others, and property destruction may occur. Notably, emotional outbursts and reactions are out of proportion with the stimuli. After episodes, remorse and embarrassment may be felt, but this does not deter future episodes from occurring.
- Onset, Incidence, Etiology: IED may begin at any age, but is common during adolescence and young adulthood. It is related to childhood exposure to trauma, neglect, or maltreatment. Other potential causes include neurotransmitter imbalances esp. of serotonin, plasma tryptophan depletion, and frontal lobe dysfunction.
- Most people with IED have a concomitant psychiatric condition e.g. (most commonly) substance use/abuse, ADHD, ODD, conduct disorder, anxiety disorders, and depression.
Treatment and Management
- Pharmacologic Treatment:
- Fluoxene (Prozac)
- Lithium
- Anticonvulsant Mood Stabilizers e.g. Valproic Acid (Depakote), Phenytoin (Dilantin), Topiramate (Topamax), and Oxcarbazepine (Trileptal).
- Serotonin Reuptake Inhibitors Antidepressants (SSRIs) seem to reduce aggressive impulses and irritability in many people, but do not eliminate the outbursts.
- Other treatments may be used such as cognitive behavioral therapy, anger management strategies, avoidance of alcohol and other substances, and relaxation techniques.