Hostname: page-component-669899f699-chc8l Total loading time: 0 Render date: 2025-04-27T01:17:24.412Z Has data issue: false hasContentIssue false
  • English
  • Français

Central Serotonin and Impulsive Aggression

Published online by Cambridge University Press:  06 August 2018

Emil F. Coccaro
Emil F. Coccaro*
Affiliation:
Clinical Neuroscience Research Unit, Department of Psychiatry, Eastern Pennsylvania Psychiatric Institute, Medical College of Pennsylvania, Philadelphia
Get access Rights & Permissions [Opens in a new window]

Extract

The role of central serotonergic (5-HT) system dysfunction in the regulation of aggression in both animals and man has been investigated for more than the past two decades. Evidence for reduced central 5-HT in the mediation of aggression comes from both behavioural and correlative studies. Functional reduction and augmentation of 5-HT activity is respectively associated with increased and decreased aggression in various animal models of aggression. While similar studies in man have not been performed, strong and consistent associations between indices reflecting reduced pre-synaptic 5-HT activity and aggression have been reported. Evidence of post-synaptic receptor upregulation in the brains of suicide victims has also been reported leaving the functional status 5-HT activity in such patients an open question. However, reduced neuroendocrine (i.e. prolactin) responses to fenfluramine, a 5-HT uptake inhibitor/releaser, which activates both pre- and post-synaptic sides of the 5-HT synapse, strongly suggest that overall central 5-HT activity is reduced in mood and/or personality disorder patients with history of suicidal and/or impulsive aggressive behaviour. Preliminary data with the 5-HT receptor agonist m-chlorophenylpiperazine further suggest that reduced activity of post-synaptic 5-HT receptors may be an important correlate of impulsive aggressive behaviour. Pharmacological agents with potent 5-HT pre- and/or post-synaptic augmenting effects should be tested clinically to determine their efficacy in the treatment of impulsive aggressive behaviour in psychiatric patients.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 155 , Issue S8: SEROTONIN IN BEHAVIOURAL DISORDERS , December 1989 , pp. 52 - 62
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Ågren, H. (1983) Life at risk: markers of suicidality in depression. Psychiatric Development, 1, 87–104.Google ScholarPubMed
Arora, C. & Meltzer, H.Y. (1989) Serotonergic measures in the brains of suicide victims: 5-HT2 binding sites in the frontal cortex of suicide victims and control subjects. American Journal of Psychiatry, 146, 730–736.Google ScholarPubMed
Åsberg, M., Schalling, D., Träksmann-Bendz, L. et al (1987) Psychobiology of suicide, impulsivity, and related phenomena. In Psychopharmacology: Third Generation of Progress, (ed Meltzer, H.Y.), pp. 655–688, New York: Raven Press.Google Scholar
Berglund, M. (1984) Suicide in alcoholism — a prospective study of 88 suicides: I. The multidimensional diagnosis at first admission. Archives of General Psychiatry, 41, 888–891.Google Scholar
Berrettini, W.H., Nurnberger, J.I. Jr, Narrow, W., et al (1986) Cerebrospinal fluid studies of bipolar patients with an without a history of suicide attempts. Annals of New York Academy of Sciences, 487, 197–201.Google Scholar
Berzsenyi, P., Galateo, E. & Valzelli, L. (1983) Fluoxetine activity of muricidal aggression induced in rats by p-chlorophenylalanine. Aggressive Behavior, 9, 333–338.Google Scholar
Beskow, J., Gottfries, C.-G., Roos, B.-E. et al (1976) Determination of monoamine and monoamine metabolites in the human brain: post mortem studies in a group of suicides and in a control group. Acta Psychiatrica Scandinavica, 53, 7–20.Google Scholar
Blackshear, M.A., Steranka, L.R. & Sanders-Bush, E. (1981) Multiple serotonin receptors: regional distribution and effect of raphe lesions. European Journal of Pharmacology, 76, 325–334.CrossRefGoogle ScholarPubMed
Bourne, H.R., Bunney, W.E. Jr., Colburn, R.W., et al (1968) Noradrenaline, 5-hydroxytryptamine, and 5-hydroxyindoleacetic acid in hindbrains of suicidal patients. Lancet, ii, 805–808.CrossRefGoogle Scholar
Branchey, L., Branchey, M., Shaw, S. et al (1984) Depression, suicide, and aggression in alcoholics and their relationship to plasma amino acids. Psychiatry Research, 12, 219–226.CrossRefGoogle ScholarPubMed
Broderick, P. & Lynch, V. (1982) Behavioural and biochemical changes induced by lithium and L-tryptophan in muricidal rats. Neuropharmacology, 21, 671–679.Google Scholar
Brown, G.L. & Goodwin, F.K. (1984) Diagnostic, clinical and personality characteristics of aggressive men with low 5-HIAA. Clinical Neuropharmacology, 7, S408–S409.Google Scholar
Brown, G.L., Goodwin, F.K., Ballenger, J.C., et al (1979) Aggression in humans correlates with cerebrospinal fluid amine metabolites. Psychiatry Research, 1, 131–139.Google Scholar
Brown, G.L., Ebert, M.H., Goyer, P.F., et al (1982) Aggression, suicide, and serotonin: relationships to CSF amine metabolites. American Journal of Psychiatry, 139, 741–746.Google Scholar
Brown, G.L., Klein, W.J., Goyer, P.F., et al (1985) Relationship of childhood characteristics of CSF 5HIAA in aggressive adults. Presented at IVth World Congress of Biological Psychiatry (Abstract 216.3), Philadelphia, Pa.Google Scholar
Bunney, W.E. Jr., & Garland-Bunney, B.L. (1987) Mechanisms of action of lithium in affective illness: basic and clinical implications. In Psychopharmacology: Third Generation of Progress (ed. Meltzer, H.Y.) pp. 553–565, New York: Raven Press.Google Scholar
Buss, A.H. & Durkee, A. (1957) An inventory for assessing different kinds of hostility. Journal of Consulting Psychiatry, 21, 343–349.CrossRefGoogle ScholarPubMed
Campbell, M., Small, A., Green, W.H., et al (1984) Behavioral efficacy of haloperidol and lithium carbonate: a comparison in hospitalized aggressive children with conduct disorder. Archives of General Psychiatry, 41, 650–656.CrossRefGoogle ScholarPubMed
Chamberlain, B.G., Ervin, F.R., Pihl, R.O. et al (1987) The effect of raising or lowering tryptophan levels on aggression in vervet monkey. Pharmacology Biochemistry Behavior, 28, 503–510.CrossRefGoogle ScholarPubMed
Cheetham, S.C., Crompton, M.R., Katona, C.L.E., et al (1988) Brain 5-HT2 receptor binding sites in depressed suicide victims. Brain Research, 443, 272–280.Google Scholar
Coccaro, E.F. & Murphy, D.L. (eds). Serotonin in Major Psychiatric Disorders. American Psychiatric Press, Washington D.C. (in press).Google Scholar
Coccaro, E.F., Siever, L.J., Klar, H.M., et al (1989) Serotonergic studies in affective and personality disorder patients: correlates with suicidal and impulsive aggressive behavior. Archives of General Psychiatry, 46, 587–599.Google Scholar
Conn, P.J. & Sanders-Bush, E. (1986) Regulation of serotonin-stimulated phosphoinositide hydrolysis: relation to the 5-HT-2 binding site. Journal of Neuroscience, 6, 3669–3675.Google Scholar
Copenhaver, J.H., Schalock, R.L. & Carver, M.J. (1978) Parachloro-D, L-phenylalanine induced filicidal behavior in the female rate. Pharmacology, Biochemistry & Behavior, 8, 263–270.Google Scholar
Cowdry, R.W. & Gardner, D.L. (1988) Pharmacotherapy of borderline personality disorder: alprazolam, carbamazepine, trifluroperazine, and tranylcypromine. Archives of General Psychiatry, 45, 111–119.CrossRefGoogle Scholar
Crow, T.J., Cross, A.J., Cooper, S.J., et al (1984) Neurotransmitter receptors and monoamine metabolites in brains of patients with Alzheimer-type dementia and depression, and suicides. Neuropharmacology, 23, 1561–1569.CrossRefGoogle ScholarPubMed
Depue, R.A. & Spoont, M.R. (1986) Conceptualizing a serotonin trait: a behavioral dimension of constraint. Annals of New York Academy of Sciences, 487, 47–62.Google Scholar
Elliot, F.A. (1977) Propranolol for the control of belligerent behavior following acute brain damage. Annals of Neurology, 1, 489–491.Google Scholar
Facchinetti, F., Martignoni, E., Nappi, G., et al (1987) Ritanserin, a serotonin-S2 receptor antagonist, does not prevent 5-hydroxytryptophan-induced β-EP, β-LPH and cortisol secretion. Hormone Research, 27, 42–46.Google Scholar
Ferrier, I.N., McKeith, I.G., Cross, A.J., et al (1986) Postmortem neurochemical studies in depression. Annals of New York Academy of Sciences, 487, 128–142.CrossRefGoogle ScholarPubMed
Garattini, S., Giacolone, E. & Valzelli, L. (1969) Biochemical changes during isolation-induced aggressiveness in mice. In Aggressive Behavior (eds Garattini, S. & Sigg, E.G.), pp. 179–187, New York: John Wiley.Google Scholar
Goldberg, S.C., Schulz, S.C., Schulz, P.M., et al (1986) Borderline and schizotypal personality disorders treated with low-dose thiothixine versus placebo. Archives of General Psychiatry, 43, 680–686.CrossRefGoogle Scholar
Greenberg, A.S. & Coleman, M. (1976) Depressed 5-hydroxyindole levels associated with hyperactive and aggressive behavior. Archives of General Psychiatry, 33, 331–336.CrossRefGoogle ScholarPubMed
Gross-Isseroff, R., Israeli, M. & Biegon, A. (1989) Autoradiographic analysis of tritiated imipramine binding in the human brain post mortem: effects of suicide. Archives of General Psychiatry, 46, 237–241.Google Scholar
Gudelsky, G.A., Koenig, J.I. & Meltzer, H.Y. (1986) Thermoregulatory responses to serotonin (5-HT) receptor stimulation in the rat: evidence for opposing roles of 5-HT2 and 5-HT1a receptors. Neuropharmacology, 25, 1307–1313.CrossRefGoogle Scholar
Hjorth, S. & Carlsson, A. (1986) Is pindolol a mixed agonist/antagonist at central serotonin (5-HT) receptors? European Journal of Pharmacology, 129, 131–138.Google Scholar
Hodge, G.K. & Butcher, L.L. (1975) Catecholamine correlates of isolation-induced aggression in mice. European Journal of Pharmacology, 31, 81–93.Google Scholar
Hoyer, D. (1988) Functional correlates of serotonin 5-HT1 recognition sites. Journal of Receptor Research, 8, 59–81.Google Scholar
Kantak, K.M., Hegstrand, L.R. & Eichelman, B. (1981) Facilitation of shock-induced fighting following intraventricular 5,7-dihydroxytryptamine and 6-hydroxydopa. Psychopharmacology, 74, 157–160.Google Scholar
Katz, R.J. (1980) Role of serotonergic mechanisms in animal models of predation. Progress in Neuro-Psychopharmacology, 4, 219–231.CrossRefGoogle ScholarPubMed
Koella, W.P., Levin, P. & Baltzer, V. (1975) The pharmacology of carbamazepine and some other anti-epileptic drugs. In Epileptic Seizures – Behavior – Pain (ed. Birkmeyer, W.) pp. 32–50, Vol. 3. Bern, Switzerland: Hans Huber.Google Scholar
Korpi, E.R., Klineman, J.E., Goodman, S.I., et al (1986) Serotonin and 5-hydroxyindoleacetic acid concentrations in brains of suicide victims: comparison in chronic schizophrenic with suicide as cause of death. Archives of General Psychiatry, 43, 594–600.CrossRefGoogle ScholarPubMed
Kuhn, C.M., Vogel, R.A., Mailman, R.B., et al (1981) Effect of 5,7-dihydroxytryptamine on serotonergic control of prolactin secretion and behavior in rats. Psychopharmacology, 73, 188–193.CrossRefGoogle ScholarPubMed
Langer, S.Z., Galzin, A.M., Poirier, M.F., et al (1987) Association of [3H]-imipramine and [3H]-paroxetine binding with the 5HT transporter in brain and platelets: relevance to studies in depression. Journal of Receptor Research, 7, 499–521.Google Scholar
Lee, T. & Tang, S.W. (1984) Loxapine and clozapine decrease serotonin (S2) but do not elevate dopamine (D2) receptor numbers in the rat brain. Psychiatry Research, 12, 277–285.CrossRefGoogle Scholar
Lewis, D.A. & Sherman, B.M. (1985) Serotonergic regulation of prolactin and growth hormone secretion in man. Acta Endocrinologica, 110, 152–157.Google Scholar
Leyson, J.E., Van Gompel, P., Gommeren, W., et al (1986) Down regulation of serotonin-S2 receptor sites in rat brain by chronic treatment with the serotonin-S2 antagonists: ritanserin and setoperone. Psychopharmacology, 88, 434–444.Google Scholar
Lidberg, L., Tuck, J.R., Åsberg, M., et al (1985) Homicide, suicide and CSF 5-HIAA Acta Psychiatrica Scandinavica, 71, 230–236.Google Scholar
Linnoila, M., Virkkunen, M., Scheinen, M., et al (1983a) Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior. Life Sciences, 33, 2609–2614.Google Scholar
Linnoila, M., Karoum, F., Rosenthal, N., et al (1983b) Electroconvulsive treatment and lithium carbonate. Their effects on norepinephrine metabolism in patients with primary, major depressions. Archives of General Psychiatry, 40, 677–680.Google Scholar
Linnoila, M., Karoum, F. & Potter, W.Z. (1983c) Effects of antidepressant treatments on dopamine turnover in depressed patients. Archives of General Psychiatry, 40, 1015–1017.CrossRefGoogle ScholarPubMed
Lloyd, K.G., Farley, I.J., Deck, J.H.N., et al (1974) Serotonin and 5-hydroxyindoleacetic acid in discrete areas of the brainstem of suicide victims and control patients. Advances in Biochemical Psychopharmacology, 11, 387–397.Google Scholar
Mann, J.J., Stanley, M., McBride, P.A., et al (1986) Increased serotonin2 and β-adrenergic receptor binding in the frontal cortices of suicide victims. Archives of General Psychiatry, 43, 954–959.Google Scholar
Marks, P.C., O'Brien, M. & Paxinos, G. (1977) 5,7-DHT-induced muricide: inhibition as a result of exposure of rats to mice. Brain Research, 135, 383–388.Google Scholar
McBride, P.A., Anderson, G.M., Hertzig, M.E., et al (1989) Serotonergic responsivity in male young adults with autistic disorder. Archives of General Psychiatry, 46, 213–221.CrossRefGoogle ScholarPubMed
McMillen, B.A., Scott, S.M., William, H.L. & Sanghera, M.K. (1987) Effect of gepirone, an aryl-piperazine anxiolytic drug, on aggressive behavior and brain monoaminergic neurotransmission. Naunyn-Schmiedeberg's Archives of Pharmacology, 335, 454–464.Google Scholar
McMillen, B.A., Chamberlain, J.K., DaVanzo, J.P. (1988) Effects of housing and muricidal behavior on serotonergic receptors and interactions with novel anxioytic drugs. Journal of Neurotransmission, 71, 123–132.Google Scholar
Meltzer, H.Y. & Lowy, M.T. (1987) The serotonin hypothesis of depression. In Psychopharmacology: Third Generation of Progress (ed. Meltzer, H.Y.) pp. 513–526. New York: Raven Press.Google Scholar
Meltzer, H.Y., Perline, R., Tricou, B.J., et al (1984) Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II: Relation to suicide, psychosis, and depressive symptoms. Archives of General Psychiatry, 41, 379–387.Google Scholar
M⊘ller, S.E. (1980) Evaluation of the relative potency of individual competing amino acids to tryptophan transport in endogenously depressed patients. Psychiatry Research, 3, 141–150.CrossRefGoogle Scholar
Molina, V.A., Gobaille, S. & Mandel, P. (1986) Effects of serotonin-mimetic drugs on mouse-killing behavior. Aggressive Behavior, 12, 201–211.Google Scholar
Montgomery, S.A. & Montgomery, D. (1982) Pharmacological prevention of suicidal behavior. Journal of Affective Disorders, 4, 291–298.CrossRefGoogle Scholar
Morand, C., Young, S.N. & Ervin, F.R. (1983) Clinical response of aggressive schizophrenics to oral tryptophan. Biological Psychiatry, 18, 575–578.Google ScholarPubMed
Mueller, E.A., Murphy, D.L. & Sunderland, T. (1985) Neuroendocrine effects of M-chlorophenylpiperazine, a serotonin agonist, in humans. Journal of Clinical Endocrinology and Metabolism, 61, 1179–1184.Google ScholarPubMed
Mueller, E.A., Murphy, D.L. & Sunderland, T. (1986) Further studies of the putative serotonin agonist, m-chlorophenylpiperazine: evidence for a serotonin receptor mediated mechanism of action in humans. Psychopharmacology, 89, 388–391.Google ScholarPubMed
Meyerson, L.R., Wennogle, L.P., Abel, M.S., et al (1982) Human brain receptor alterations in suicide victims. Pharmacology Biochemistry & Behavior, 17, 159–163.CrossRefGoogle ScholarPubMed
Olivier, B., Van Aken, H., Jaarsma, I., et al (1984) Behavioural effects of psychoactive drugs on agonistic behaviour of male territorial rats (resident-intruder model). In Ethopharmacological Aggression Research, pp. 137–156 (eds Olivier, B., Miczek, K.A. & Kruk, M.R.). New York: Alan R. Liss.Google Scholar
Ortmann, R., Bischoff, S. & Radeke, E. (1982) Correlations between different measures of antiserotonin activity of drugs: study with neuroleptics and serotonin receptor blockers. Naunyn-Schmiedebergs Archives of Pharmacology, 321, 265–270.Google Scholar
Owen, F., Chambers, D.R., Cooper, S.J., et al (1986) Serotonergic mechanisms in brains of suicide victims. Brain Research, 362, 185–188.Google Scholar
Pare, C.M.B., Yeung, D.P.H., Price, K., et al (1969) 5-Hydroxytryptamine, noradrenalin, and dopamine in brainstem, hypothalamus and caudate nucleus of controls and of patients committing suicide by coal-gas poisoning. Lancet, ii, 133–135.Google Scholar
Paul, S.M., Rehavi, M., Skolnick, P., et al (1984) High affinity binding of antidepressants to biogenic amine transport sites in human brain and platelet: studies in depression. In Neurobiology of Mood Disorders (eds Post, R.M. & Ballenger, J.C.) pp. 846–853. Baltimore: Williams & Wilkins.Google Scholar
Pericic, D. & Manev, H. (1988) Behavioural evidence for simultaneous dual changes of 5-HY receptor subtypes: Mode of antidepressant action? Life Sciences, 42, 2593–2601.Google Scholar
Petraglia, P., Facchinetti, F., Martignoni, E., et al (1984) Serotonergic agonists increase plasma levels of β-endorphin and β-lipotropin in humans. Journal of Endocrinology and Metabolism, 59, 1138–1142.Google ScholarPubMed
Plisza, S.R., Rogeness, G.A., Renner, P., et al (1988) Plasma neurochemistry in juvenile offenders. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 588–594.CrossRefGoogle Scholar
Post, R.M., Rubinow, D.R., Uhde, T.W., et al (1985) Effects of carbamazepine on noradrenergic mechanisms in affectively ill patients. Psychopharmacology, 87, 59–63.Google Scholar
Pratt, J.A., Jenner, P., Johnson, A., et al (1984) Anticonvulsant drugs alter plasma tryptophan concentrations in epileptic patients: implications for antiepileptic action and mental function. Journal of Neurology, Neurosurgery and Psychiatry, 47, 1131–1133.Google Scholar
Quattrone, A., Schettini, G., DiRenzo, G.F., et al (1979) Effect of midbrain raphe lesion or 5,7-dihydroxytryptamine treatment on the prolactin-releasing action of quipazine and d-fenfluramine in rats. Brain Research, 174, 71–79.Google Scholar
Quattrone, A., Tedeschi, G., Aguglia, F., et al (1983) Prolactin secretion in man: a useful tool to evaluate the activity of drugs on central 5-hydroxytryptaminergic neurones: studies with fenfluramine. British Journal of Clinical Pharmacology, 16, 471–475.Google Scholar
Quik, M. & Azmitia, E. (1983) Selective destruction of the serotonergic fibers of the fornix-fimbria and cingulum bundle increases 5-HT2 receptors in rat midbrain. European Journal of Pharmacology, 90, 377–384.CrossRefGoogle ScholarPubMed
Rowland, N.E. & Carlton, J. (1986) Neurobiology of an anorectic drug: fenfluramine. Progress in Neurobiology, 27, 13–62.Google Scholar
Roy, A., Adinoff, B. & Linnoila, M. (1988) Acting out hostility in normal volunteers: Negative correlation with levels of 5HIAA in cerebrospinal fluid. Psychiatry Research, 24, 187–194.Google Scholar
Roy-Byrne, P., Post, R.M., Rubinow, D.R., et al (1983) CSF 5HIAA and personal and family history of suicide in affectively ill patients: a negative study. Psychiatry Research, 10, 263–274.Google Scholar
Rydin, E., Schalling, D. & Åsberg, M. (1982) Rorschach ratings in depressed and suicidal patients with low levels of 5-hydroxyindoleacetic acid in cerebrospinal fluid. Psychiatry Research, 7, 229–243.Google Scholar
Seeman, P., Westman, K., Coscina, D., et al (1980) Serotonin receptors in hippocampus and frontal cortex. European Journal of Pharmacology, 66, 179–191.Google Scholar
Senault, B. (1970) Comportement d'aggressitive intraspécifique induit par l'apomorphine chez le rat. Psychopharmacologia, 18, 271–287.CrossRefGoogle Scholar
Sewell, R.G., Gallus, J.A., Gault, F.O., et al (1982) p-Chlorophenylalanine effects on shock-induced attack and pressing responses in rats. Pharmacology, Biochemistry & Behavior, 17, 945–950.Google Scholar
Shaw, D.M., Camps, F.E. & Eccleston, E.G. (1967) 5-Hydroxytryptamine in the hind-brain of depressive suicides. British Journal of Psychiatry, 113, 1407–1411.Google Scholar
Sheard, M.H., Marini, J.L., Bridges, C.I., et al (1976) The effect of lithium on impulsive aggressive behavior in man. American Journal of Psychiatry, 133, 1409–1413.Google Scholar
Siever, L.J. (1987) Role of noradrenergic mechanisms in the etiology of the affective disorders. In Psychopharmacology: Third Generation of Progress (ed. Meltzer, H.Y.), pp. 493–504, New York: Raven Press.Google Scholar
Siever, L.J., Murphy, D.L., Slater, S., de la Vega, E., et al (1984) Plasma prolactin changes following fenfluramine in depressed patients compared to controls: an evaluation of central serotonergic responsivity in depression. Life Sciences, 34, 1029–1039.CrossRefGoogle ScholarPubMed
Soloff, P.H., George, A., Nathan, R.S., et al. (1986) Progress in the pharmacotherapy of borderline disorders: A double-blind study of amitriptyline, haloperidol, and placebo. Archives of General Psychiatry, 43, 691–697.Google Scholar
Sorgi, P.J., Ratey, J.J. & Polakoff, S. (1986) β-adrenergic blockers for the control of aggressive behaviors in patients with chronic schizophrenia. American Journal of Psychiatry, 143, 775–776.Google Scholar
Sorgi, P.J., Cole, L.S., Knoedler, D., et al (1988) Nadolol for chronic impulsive aggressive behavior. New Research Abstract #NR27, 141st Annual Meeting of the American Psychiatric Association, Montreal, Quebec.Google Scholar
Soubrie, P. (1989) Reconciling the role of central serotonin neurons in human and animal behavior. Behavioral and Brain Sciences, 9, 319–364.Google Scholar
Stanley, M. & Mann, J.J. (1983) Increased serotonin-2 binding sites in frontal cortex of suicide victims. Lancet, i, 214–216.Google Scholar
Stanley, M., Virgilio, J. & Gershon, S. (1982) Tritiated imipramine binding sites are decreased in the frontal cortex of suicides. Science, 216, 1337–1339.Google Scholar
Stark, P., Fuller, R.W. & Wong, D.T. (1985) The pharmacologic profile of fluoxetine. Journal of Clinical Psychiatry, 46 (3,2), 7–13.Google Scholar
Stoff, D.M., Pollack, L., Vetiello, B., et al (1987) Reduction of [3H]-imipramine binding sites on platelets of conduct-disordered children. Neuropsychopharmacology, 1, 55–62.Google Scholar
Tyrer, S.P., Walsh, A., Edwards, D.E., et al (1984) Factors associated with a good response to lithium in aggressive mentally handicapped subjects. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 8, 751–755.CrossRefGoogle ScholarPubMed
Valzelli, L. & Bernasconi, S. (1979) Aggressiveness by isolation and brain serotonin turnover changes in different strains of mice. Neuropsychobiology, 5, 129–135.CrossRefGoogle ScholarPubMed
Valzelli, L. (1981) Psychobiology of Aggression and Violence, pp. 97–121. New York: Raven Press.Google Scholar
van Praag, H.M. (1986) (Auto) aggression and CSF 5-HIAA in depression and schizophrenia. Psychopharmacology Bulletin, 22, 669–673.Google ScholarPubMed
Vergnes, M., Penot, C., Kempf, E., et al (1977) Lesion selective des neurones sérotoninergiques du raphé par la 5,7-dihydroxytryptamine: effets sur le comportement d'agression interspécifique du Rat. Brain Research, 133, 167–171.Google Scholar
Virkkunen, M., Nuutila, A., Goodwin, F.K., et al (1987) Cerebrospinal fluid metabolite levels in male arsonists. Archives of General Psychiatry, 44, 241–247.Google Scholar
Vogt, M. (1982) Some functional aspects of central serotonergic neurones. In Biology of Serotonergic Transmission (ed. Osborne, N.), pp. 299–315. Chichester: John Wiley.Google Scholar
Waldbillig, R.J. (1979) The role of the dorsal and median raphe in the inhibition of muricide. Brain Research, 160, 341–346.Google Scholar
Waldmeier, P.C., Baumann, P.A., Fehr, B., et al (1984) Carbamazepine decreases catecholamine turnover in the rat brain. Journal of Pharmacology and Experimental Therapy, 231, 166–172.Google ScholarPubMed
Wickham, E.A. & Reed, J.V. (1987) Lithium for the control of aggressive and self mutilating behaviour. International Clinical Psychopharmacol, 2, 181–190.Google Scholar
Wilmot, C.A. & Szczepanik, A.M. (1989) Effects of acute and chronic treatments with clozapine and haloperidol on serotonin (5-HT2) and dopamine (D2) receptors in the rat brain. Brain Research, 487, 288–298.Google Scholar
Worrell, E.P., Moody, J.P. & Naylor, G.J. (1975) Lithium in nonmanic-depressives: Antiaggressive effect and red blood cell lithium values. British Journal of Psychiatry, 126, 464–468.Google Scholar
Yen, C.Y., Stangler, R.L. & Millman, N. (1959) Ataractic suppression of isolation-induced aggressive behavior. Archives of International Pharmacodynamics, 123, 179–185.Google Scholar
Yudofsky, S., Williams, D. & Gorman, J. (1981) Propranolol in the treatment of rage and violent behavior in patients with chronic brain syndromes. American Journal of Psychiatry, 138, 218–220.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.