Effectiveness of carbamazepine for benzodiazepine‐resistant impulsive aggression in a patient with frontal infarctions

• Published in: Psychiatry and clinical neurosciences 2007-12, Vol.61 (6), p.695-697
• Main Authors: NAGATA, TOMOYUKI, HARADA, DAISUKE, AOKI, KIMIYOSHI, KADA, HIROHIDE, MIYATA, HISATSUGU, KASAHARA, HIROO, NAKAYAMA, KAZUHIKO
• Format: Article
• Language: English
• Subjects: Aggression - drug effects; Aggression - psychology; Antimanic Agents - therapeutic use; benzodiazepine resistance; Benzodiazepines - therapeutic use; Biological and medical sciences; carbamazepine; Carbamazepine - therapeutic use; Cerebral Infarction - complications; Cerebral Infarction - pathology; Cerebral Infarction - psychology; Drug Resistance; Electroencephalography; Frontal Lobe - pathology; frontal lobe infarction; Humans; Hypnotics and Sedatives - therapeutic use; impulsive aggression; Impulsive Behavior - drug therapy; Impulsive Behavior - etiology; Impulsive Behavior - psychology; Irritable Mood - drug effects; Male; Medical sciences; Middle Aged; Moyamoya disease; Moyamoya Disease - complications; Moyamoya Disease - pathology; Neuropharmacology; Paresthesia - drug therapy; Pharmacology. Drug treatments; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychomotor Agitation - drug therapy; Psychomotor Agitation - etiology; Psychopathology. Psychiatry; Psychopharmacology
• ISSN: 1323-1316; 1440-1819
• DOI: 10.1111/j.1440-1819.2007.01737.x

Anticonvulsants have been used for the treatment of impulsive aggression since the 1980s. A 50‐year‐old man suffered from irritability and agitation after developing a right ipsilateral frontal lobe infarction as a result of Moyamoya disease; these symptoms caused difficulties with his working and interpersonal relationships. The patient had been treated using multiple benzodiazepine agents for 2 years but his symptoms had not improved. However, after treatment with carbamazepine (CBZ; 200 mg) was begun, the patient's irritability and agitation gradually decreased. The efficacy of CBZ treatment in this patient suggests a method for controlling benzodiazepine‐resistant impulsive aggression.