Drugs that regulate serotonin do not decrease the relapses of violent episodes compared to placebo, as previously hypothesized.
Can antidepressant medications be used to reduce impulsive violent behaviors? In the past it was hypothesized that they could have some effectiveness, but now a clinical study conducted in Australia disproves this idea: drugs that modulate serotonin have no effect in decreasing episodes of impulsive violence compared to placebo. The research was published in the journal eClinicalMedicineof the group of Lancet.
Aggression and serotonin
The study, conducted by the University of New South Wales, Australia, is based on a double link: that between poor impulse control and aggressive behaviour, which can lead to episodes of violence; and that between this type of behavior and reduced levels of serotonin, a neurotransmitter essential for mood regulation.
Hence the idea that sertraline, a common antidepressant of the class of selective serotonin reuptake inhibitors (SSRI) which is usually prescribed against depression, anxiety disorders or obsessive-compulsive disorders, could reduce the aggressive tendencies of impulsivity in subjects who repeat this type of behavior.
How it ended
Between 2013 and 2021, researchers randomly assigned 630 adult men with at least two previous violent crime convictions and high levels of aggression to 100 mg of oral sertraline daily or a placebo. Within a year of taking the drug, a violent crime occurred in 72 (22.6%) of the 319 participants who had unknowingly taken sertraline, and in 70 (22.5%) of the 311 assigned to placebo.
Therefore, sertraline did not significantly reduce the risk of recidivism of impulsive violence compared to placebo.
Post-hoc analyses, i.e. those which are carried out to discover if there are differences between the various groups, after a preliminary test has already indicated the general outcome of the experiment, have suggested a possible, minimal effect on recidivism of domestic violence. But critics of the study have long underlined that this is a controversial aspect, because that kind of violence is not so much a question of lack of impulse control, but rather a form of deliberate and systematic control of the partner or other family members (to delve deeper into the effects of violence on the brain, and on the entire organism, of women, listen to the dedicated episode of Prisma – The Why of Things).
