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Dorothea Dix Hospital, Raleigh, North Carolina 27611.
A substantial body of research with both animals and humans demonstrates that pharmacologic modulation of three neurotransmitter systems (the GABAergic, the noradrenergic, and the serotonergic) and electrical stimulation of regions of the brain produce marked alterations in aggressive and violent behavior. The author reviews this research and uses case reports to illustrate how it has been applied in the development of a rational pharmacotherapy for violent patients. Four basic principles of clinical application that can enhance trials of pharmacologic treatment of the violent patient are identified. Evidence suggests that behavioral and social learning approaches to the treatment of violence can be more effective when administered after the patient has been stabilized through pharmacologic interventions.
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