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Serotonin reduces impulsive unprovoked aggression, whether directed against others or the self. This three-month, double-blind, placebo-controlled study evaluated the anti-aggressive efficacy of fluoxetine (20 to 60 mg/day) in 40 patients with personality disorders and a prominent history of impulsive aggression, but not major depressive disorder, bipolar disorder, or schizophrenia. The results provide additional evidence that serotonin reuptake inhibitors can diminish impulsive aggression independent of their antidepressant action.
The most common personality disorders in these patients were in the dramatic cluster, although anxious and eccentric clusters and personality disorder not otherwise specified were also represented, and many patie…