[Anger outbursts in unipolar depressive disorders]

Area of Science:

• Psychiatry
• Neuroscience
• Pharmacology

Context:

• Anger attacks are a distinct symptom cluster in approximately one-third of depressed outpatients.
• These episodes involve sudden anger with autonomic activation, perceived as uncharacteristic and situationally inappropriate.
• Patients with anger attacks exhibit higher anxiety, hostility, and are more prone to personality disorders.

Purpose:

• To investigate the prevalence and characteristics of anger attacks in depressed outpatients.
• To evaluate the efficacy and safety of antidepressant treatment for anger attacks.
• To explore the potential role of serotonergic agents in managing this symptom.

Summary:

• Antidepressant treatment, including fluoxetine (Prozac), sertraline, and imipramine, effectively resolves anger attacks in 53-71% of depressed patients.
• The emergence rate of anger attacks post-treatment with fluoxetine is comparable to other antidepressants and lower than placebo.
• Serotonergic antidepressants are hypothesized to be particularly effective due to their role in modulating aggressive behavior.

Impact:

• Findings support the use of antidepressants for managing anger attacks in depression.
• Suggests a potential link between serotonergic activity and the effectiveness of treatment for anger attacks.
• Highlights the need for further research comparing selective serotonin reuptake inhibitors with other antidepressant classes.