Aggressive behavior is defined as excessive verbal abuse or physical acts of violence toward oneself or others. It could involve cursing, making threats, throwing objects and threatening or actually using weapons against another person, object or animal. Compared to the general population, those with aggressive behavior traits have an increased risk of becoming violent. Underlying causes may be related to alcohol abuse, drug use, psychiatric disorders, brain injuries and even an unstable home. Treating aggressive behavior can be done in three stages: immediate treatment, a behavioral approach to curtail the outburst and long-term treatment.
Acute management
The first step in treating aggressive behavior is acute management, which focuses on immediately calming the patient, according to Dr. Leslie Citrome of New York University Langone Medical Center. Quickly addressing aggressive behavior will help the patient relax and prevent a prolonged episode. Lorazepam is a benzodiazepine medication that is used to treat anxiety. It has also proven effective in the treatment of patients with the potential to become violent. Benzodiazepines can help with alcohol withdraw and an underlying bipolar disorder. Sedatives such as haloperidol and droperidol are used to calm the patient so that a further medical analysis may be conducted.
Behavioral Approaches
When assessing a patient with aggressive behavior, clinicians should always maintain eye contact, talk softly and ask the patient what it would take to relax them. Any number of situations could be exacerbating the person's mood, from lack of sleep, hunger or a dispute. Having the chance to express his feelings could de-escalate his outburst and prevent further aggressive action.
Long-term Management
Once a patient is stabilized, a long-term management goal should be established to reduce the frequency and intensity of episodes. Patients can benefit from the safety of a secure, psychiatric unit where medical professionals can observe their behavior. Further, this setting will prevent the patient from acting out violently toward others. Medications that have proved successful in the treatment of aggression include atypical antipsychotics and mood stabilizers. Serotonin-specific reuptake inhibitors (SSRIs) also may be helpful. Studies have shown that clozapine, an atypical antipsychotic, helps reduce hostility. It also can minimize delusional thinking and hallucinations. Patients who are treated with the mood stabilizer valproate show a reduction in violent and agitated behaviors. Lexapro and Paxil are well-known SSRIs used to treat stress, anxiety and depression.
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