Anger management medication does not specifically target the emotion of ‘anger’ itself, however it can help through:
- Providing support during the time an individual aims to break their addiction to it.
- Complementing the healing process.
Anti-anger medications can include both conventional and complementary approaches. Conventional pharmaceuticals typically refer to prescription and over-the-counter drugs, whilst those of a complementary or alternative nature imply herbal medicines, tinctures, teas and supplements. The following article will focus on the former whilst natural options will be covered elsewhere on this site.
In addition to the use of medications, anti-anger therapies and techniques can have an important role to play in overcoming anger problems e.g. group therapy sessions.
Anger Medication Best Practice
Ideally, the optimal approach to dealing with a patient who presents with anger issues would be to:
- Firstly, determine the condition (underlying cause) rather than simply treat the symptoms. Aside from issues such as low self-esteem or abuse, the causes of anger range on a spectrum from the seemingly innocuous e.g. inappropriate diet (such as too much sugar or caffeine) or having a food sensitivity, through to chronic problems e.g. sleep apnea, as well as numerous serious disorders e.g. severe paranoid personality disorder (PPD).
Examples of underlying causes that can be associated with anger include:
ADHD, Alzheimer’s disease, autism, bipolar disorder, depression, dementia, diabetes, drug abuse, hyperthyroidism (overactive thyroid), infections e.g. Lyme disease (Borrelia spp) and co-infections such as Bartonellosis (Bartonella spp), personality disorders, premenstrual syndrome (PMS), prescription medication e.g. statins, sleep conditions, trauma e.g. head or emotional, as well as tumors etc.
- Secondly, treat the condition (not ‘anger’ itself) that produces anger symptoms using non-medicinals e.g. cognitive behavioral therapy (CBT).
- Thirdly, consider treating the condition using non-prescription alternatives e.g. herbal teas (Chamomile or Passionflower) or supplements such as omega-3 (Buydens-Branchey et al. 2007 suggested EPA lowers anxiety and DHA lowers anger).
- Lastly, treat the condition using prescription medication e.g. antidepressants.
When a person has a first consultation with their practitioner, the doctor (depending on their specialism and whether they deem the anger problem to be of particular cause for concern) will typically steer the patient to consider non-prescription alternatives. However, if the problem is notable or a non-prescription approach is unsuccessful, the practitioner may then decide to carry out various blood tests as well as refer the patient for a psychiatric consultation. A multi-pronged approach such as this can help pinpoint the underlying root cause of a person’s anger.
If medicine is prescribed, it is usual to start with the mildest treatment at the lowest dose that produces satisfactory results. Remember though that everyone is unique; a particular medication for anger and irritability may prove very helpful to one individual yet yield poor results for another person. Moreover, the side effects of a given drug affect everyone differently; most people may have no obvious negative affects, some just minor issues e.g. slight nausea or fatigue, whilst a small number may experience potentially serious problems e.g. heart arrhythmia or liver dysfunction, and in rare cases, life-threatening symptoms may arise e.g. anaphylactic shock.
In addition, certain anti-anger medications may have an addictive quality which means the person must take the prescribed dose on a regular basis in order to prevent withdrawal symptoms. Should it be necessary to stop these types of medicine, the dosage is usually reduced over a period of time in order to allow the body to adjust to the chemical changes taking place within.
Factors Determining Anger Medicine Success
Achieving a successful outcome using anger management medication may involve the interplay of a number of factors such as:
- Correct diagnosis of the underlying cause. This can be compounded in the case of co-occurring disorders e.g. someone with a personality disorder who abuses recreational drugs.
- Biological makeup of the anger-prone individual.
- The suitability and effectiveness of the medication taken.
- Severity of medicine side effects.
- Appropriate ongoing medication management and progress assessment.
- The support network available to the patient e.g. family support increases the chances of a successful outcome by ensuring encouragement through difficult times.
- Does the patient honestly acknowledge that they have an anger problem and how motivated are they to stop their addiction to it?
Types of Anger Management Medication
All 5 categories of psychiatric medications can produce anti-anger effects and these include the following:
ANTIDEPRESSANTS – Create a calming effect although apathy can result from too high a dose.
SSRIs (Selective Serotonin Re-Uptake Inhibitors) are a common class of drug used in this category e.g. Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil) and Sertraline (Zoloft).
MAOIs (Monoamine Oxidase Inhibitors) e.g. Phenelzine (Nardil) and Tricyclic Antidepressants e.g. Amitriptyline (Elavil) can be used to treat certain anger-related conditions.
ANTIPSYCHOTICS – Help treat psychotic disorders.
Includes 1st and 2nd generation drugs such as Chlorpromazine (Thorazine) or Haloperidol (Haldol) as compared to Aripiprazole (Abilify), Olanzapine (Zyprexa), Paliperidone (Invega), Quetiapine (Seroquel) and Risperidone (Risperdal).
ANXIOLYTICS – Anti-anxiety medications that have a sedative effect.
Benzodiazepines tend to be addictive; the dosage may need to be increased over time because their effectiveness declines as the body adapts to them e.g. Alprazolam (Xanax), Diazepam (Valium) or Lorazepam (Ativan). However, Clonazepam (Klonopin) appears less prone to this issue.
Non-benzodiazepine sedatives such as Zolpidem (Ambien) are sometime used but as with any medication, side effects can still arise e.g. disturbed sleep patterns.
MOOD STABILIZERS – Help to level out the ‘highs’ and ‘lows’.
Lithium is the classic example of this category of drug although there are many other possibilities e.g. Carbamazepine (Carbatrol), Valproate (Depakote) or Lamotrigine (Lamictal).
STIMULANTS – These may help specific conditions where anger can be an issue e.g. ADHD.
Examples of medication in this category include Dextroamphetamine and Amphetamine (Adderall), Dexmethylphenidate (Focalin) and Methylphenidate (Ritalin). However, the use of stimulants for the majority of anger-related conditions can be detrimental leading to enhanced mood swings, increased volatility and aggressive behavior with the potential of violence.
Be aware that drugs exhibiting anti-anger effects can sometimes be categorized in various ways. For example, Lamotrigine (Lamictal) is an anticonvulsant and mood stabilizer whereas Topiramate (Topamax) is an anticonvulsant and nerve pain medication. Azapirones e.g. Buspirone (BuSpar) or Perospirone (Lullan), are a class of drug that display anxiolytics and antipsychotics characteristics.
Furthermore, good results can sometimes be obtained from medications not necessarily associated with anti-anger treatment but primarily used to treat other conditions. For example, the anger trigger of stress or anxiety affect many people and minimizing these factors may help reduce the risk of an outburst. The use of certain antihistamines e.g. Diphenhydramine (Benadryl), have a calming effect on the body and can help reduce both anxiety and stress. Also, beta blockers e.g. Atenolo (Tenormin) or Propranolol (Inderal), can help reduce anxiety by counteracting the effect of the stress hormone adrenaline.