Reducing impulsivity in repeat violent offenders: an open label trial of a selective serotonin reuptake inhibitor

The association between serotonergic dysfunction and aggression has prompted the use of selective serotonin re-uptake inhibitors (SSRIs) as a means of controlling impulsive violent behaviour. The aim of the current study was to examine the feasibility of using an SSRI to treat impulsivity in a group of repeat violent offenders.

Potential participants were recruited from three magistrates' court complexes in the Sydney metropolitan area and all had histories of violent offending (at least one prior conviction for a violent offence). Those who scored highly on the Barratt Impulsivity Scale (BIS-11), passed medical and psychiatric evaluations and consented to treatment were prescribed sertraline (Zoloft) over a three month period.

Thirty-four individuals commenced the trial, with 20 completing the three month intervention. Reductions were observed across a range of behavioural measures from baseline to 3 months: impulsivity (35%), irritability (45%), anger (63%), assault (51%), verbal-assault (40%), indirect-assault (63%), and depression (62%). All those who completed the three month trial requested to continue sertraline under the supervision of their own medical practitioner.

Our findings suggest that treating impulsive violent individuals in the criminal justice system with an SSRI is a potential treatment opportunity for this population. An adequately powered randomized control trial of this intervention is warranted.