Pharmacotherapy

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The primary aim is control of impulsivity and aggression. Medication is also used to deal with incapacitating symptoms, such as anxiety, rage, depression, and somatic complaints.(34) Selective serotonin reuptake inhibitors and lithium may be beneficial in regulating serotonergic function. Antiepileptic drugs, such as carbamazepine and clonazepam could be used for aggressive outbursts, especially if abnormal waves are noted on the EEG. Psychostimulants such as methylphenidate (Ritalin(@)) may be useful if there is evidence of attention-deficit hyperactivity disorder. Benzodiazepines are contraindicated since they might cause behavioural disinhibition. Non-compliance and drug abuse are common problems; therefore drugs should be used judiciously.

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