A 32-year-old man with intermittent explosive disorder has frequent impulsive aggressive outbursts disproportionate to provocation. Which drug has the best evidence from randomised controlled trials as first-line pharmacotherapy for this condition?
- A Fluoxetine ✓
- B Haloperidol
- C Clonazepam
- D Carbamazepine
Correct answer: A. Fluoxetine
Explanation
Fluoxetine, an SSRI, is supported by randomised controlled trials showing reduction in impulsive aggressive episodes in intermittent explosive disorder and is regarded as first-line pharmacotherapy. Benzodiazepines are avoided because they may disinhibit aggression, killing that distractor. Anticonvulsants such as carbamazepine and antipsychotics are second-line options used when serotonergic agents fail or aggression is severe.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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