The pharmacotherapy of clinical aggression in criminal offenders

Pharmacotherapy of clinical aggression begins with assessment of the individual regarding the nature of the aggression and diagnosis. In general psychiatry, but especially in the treatment of criminal offenders, addressing aggressive behavior as well as the mental disorder is essential for safe and effective treatment. Assessment and pharmacotherapy of impulsive aggression is informed by diagnosis, identification of evidence-based anti-impulsive aggressive agents (AIAAs), AIAAs risks and side effects, severity of aggression, prescription parsimony, pharmacotherapy history, and affordability and availability. Pharmacotherapy of aggression that is secondary to a mental disorder must address both the aggressive behavior and the disorder. Illustrative examples discussed here are the pharmacotherapy of aggression secondary to bipolar disorder, schizophrenia and psychotic disorders, and traumatic brain injury respectively.