Zur Pharmakotherapie impulsiver Aggression bei antisozialen und psychopathischen Störungen

  • Alan R. FelthousEmail author
  • Matthew S. Stanford
  • Henning Saß


Impulsive Aggression stellt ein häufiges Merkmal bei psychopathischen Störungen dar und kann mit Psychopharmaka behandelt werden. Aus kontrollierten Studien ergeben sich für die folgenden gegen impulsive Aggression eingesetzten Wirkstoffe („anti-impulsive aggressive agent“, AIAA) die stärksten Wirksamkeitsnachweise: Fluoxetin, Phenytoin, Divalproex/Valproat, Carbamazepin/Oxcarbazepin und Lithiumsalz. Diese Übersichtsarbeit beschreibt, ausgehend von einer Risiko-Nutzen-Analyse und der Studienlage in den USA, die Auswahl und den Einsatz eines möglichst gut geeigneten AIAA bei Patienten mit psychopathischer Störung. Dabei werden positive und negative Gesichtspunkte für die Auswahl, die Anwendung sowie mögliche Wirkmechanismen des jeweiligen AIAA umrissen. Des Weiteren werden Möglichkeiten zur Behandlung von impulsiver Aggression bei Patienten erörtert, bei denen ein AIAA keine Besserung gebracht hat.


Aggression, Erwachsener Antikonvulsiva Impulskontrolle Lithium Serotonin-Wiederaufnahmehemmer Gewalt 

Pharmacotherapy of impulsive aggression in antisocial and psychopathic disorders


Impulsive aggression is a frequently occurring feature of psychopathic disorders and can be treated by pharmacotherapy. Controlled studies resulted in the use of the following agents for treatment of impulsive aggression (anti-impulsive aggression agents, AIAA) with the strongest evidence for efficacy: fluoxetine, phenytoin, divalproex/valproate, carbamazepine/oxycarbamazepine, and lithium. Starting from a risk-benefit analysis and research in the USA, this overview describes the selection and prescription of best possible AIAA suited for patients with psychopathic disorders. Positive and negative aspects for the selection and the prescription as well as possible mechanisms of action of the respective AIAAs are outlined. Furthermore, possibilities for the treatment of impulsive aggression in patients for whom an AIAA brought no improvement are explained.


Aggression, adult Anticonvulsants Impulse control Lithium Serotonin uptake inhibitors Violence 



A.R. Felthous, M.S. Stanford und H. Saß geben an, dass kein Interessenkonflikt besteht.


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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Alan R. Felthous
    • 1
    Email author
  • Matthew S. Stanford
    • 2
  • Henning Saß
    • 3
  1. 1.Division of Forensic Psychiatry, Department of Psychiatry and Behavioral NeuroscienceSaint Louis University School of MedicineSaint LouisUSA
  2. 2.Hope and Healing CenterHoustonUSA
  3. 3.Klinik für Psychiatrie, Psychotherapie und PsychosomatikUniversitätsklinikum der RWTHAachenDeutschland

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