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Topiramate for anger control: A systematic review.
Bindu Susan Varghese1, A Rajeev, Mark Norrish
1Department of Medical Pharmacology, Oman Medical College, P.O. 391, P.C. 321, Al Tarif, Sohar, Sultanate of Oman.
Indian Journal of Pharmacology
|September 28, 2010
Summary
Topiramate effectively reduces state and trait anger, with significant decreases in anger-out and hostility. This medication appears safe for managing anger and aggression without causing psychiatric side effects.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Uncontrolled anger is linked to various conditions beyond personality disorders, including chronic pain and PTSD.
- Differentiating anger intensity (State Anger) from frequency (Trait Anger) is crucial for assessment.
- Anger expression varies, encompassing outward expression (Anger-Out), suppression (Anger-In), and active control (Anger Control).
Purpose of the Study:
- To evaluate topiramate's efficacy in controlling anger compared to placebo.
- To assess topiramate's safety profile regarding psychiatric adverse events.
- To systematically review randomized controlled trials on topiramate for anger management.
Main Methods:
- A comprehensive literature search was conducted in MEDLINE and CENTRAL up to November 2008.
- The search strategy focused on randomized controlled trials (RCTs) involving aggressive adult participants.
- Bibliographies of reviews and identified articles were screened for eligible studies.
Main Results:
- Topiramate significantly reduced State Anger (weighted mean difference -3.16) and Trait Anger (weighted mean difference -2.93).
- Reductions were observed across Anger-Out and Anger Control measures, with minimal impact on Anger-In.
- No evidence suggested topiramate precipitated psychopathology, indicating a favorable safety profile.
Conclusions:
- Topiramate demonstrates significant effectiveness and safety in managing anger and aggression.
- Further research is warranted to confirm reproducibility and long-term efficacy.
- Topiramate shows promise as a therapeutic option for individuals experiencing uncontrolled anger.
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