disorders are associated with impulsive aggression, but some individuals
demonstrate violent outbursts of rage, which are variously referred
to as rage attacks, anger attacks, episodic dyscontrol, or intermittent
explosive disorder. Intermittent explosive disorder was first formally
conceptualized as a psychiatric disorder.
On several occasions the patient has lost control of aggressive impulses,
leading to serious assault or property destruction.
The aggression is markedly out of proportion to the seriousness of
any social or psychological stressors.
No other mental disorder or personality disorder better explains the
These symptoms are not directly caused by a general medical condition
or substance use, including medications and drugs of abuse.
Some disorders have similar or even the same symptoms. The clinician,
therefore, in his/her diagnostic attempt has to differentiate against
the following disorders which need to be ruled out to establish a
Attention-deficit / hyperactivity
Although the prevalence of intermittent explosive disorder is
unknown and considered to be rare, the disorder is
probably more common than realized and may be an important cause of
violent behavior. As presently defined, intermittent explosive disorder
is more common in men. However, women also have problematic impulsive
aggression, and some women have reported an increase in intermittent
explosive symptoms when they are premenstrual.
often need psychological treatment along with medication treatment,
and it is often very helpful to base their psychological treatment
on addiction-based models.
and Psychotherapy [ See
Therapy Section ]:
has proven quite effective
[ See Psychopharmacology
Section ] :
that patients with intermittent explosive disorders respond to
treatment with antidepressants such as tricyclic antidepressants and
serotonin reuptake inhibitors (SRIs) and mood stabilizers such as
lithium, carbamazepine, and divalproex. Psychotropic medications used
with Intermittent Explosive Disorder.
(Tegretol and others).
P henytoin (Dilantin).