A double-blind placebo-controlled crossover study of phenytoin in individuals with impulsive aggression

Stanford, Matthew S; Houston, Rebecca J; Mathias, Charles W; Greve, Kevin W; Villemarette-Pittman, Nicole R; Adams, Donald

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Volume 103, Issue 2 , Pages 193-203, 20 September 2001

A double-blind placebo-controlled crossover study of phenytoin in individuals with impulsive aggression

Matthew S Stanford
- Corresponding author. Tel.: +1-504-280-5525; fax: +1-504-280-6049
- Department of Psychology, University of New Orleans, 2001 Geology & Psychology Bldg., Lakefront, New Orleans, LA 70148-2870, USA
Rebecca J Houston
- Department of Psychology, University of New Orleans, 2001 Geology & Psychology Bldg., Lakefront, New Orleans, LA 70148-2870, USA
Charles W Mathias
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
Kevin W Greve
- Department of Psychology, University of New Orleans, 2001 Geology & Psychology Bldg., Lakefront, New Orleans, LA 70148-2870, USA
Nicole R Villemarette-Pittman
- Department of Psychology, University of New Orleans, 2001 Geology & Psychology Bldg., Lakefront, New Orleans, LA 70148-2870, USA
Donald Adams
- Jefferson Neurological Associates, Metairie, LA, USA

Received 25 January 2001; received in revised form 29 June 2001; accepted 30 June 2001.

Abstract

The present study examines the behavioral and psychophysiological effects of phenytoin (PHT) in individuals who display impulsive-aggressive outbursts. In a double-blind placebo-controlled crossover design, individuals meeting previously established criteria for impulsive aggression were administered PHT and placebo during separate 6-week conditions. The efficacy measures used were the Overt Aggression Scale (OAS) and the Profile of Mood States (POMS). Psychophysiological measures (evoked potentials) were taken at baseline and at the end of each 6-week condition. Photic stimulation was used to evoke the mid-latency P1–N1–P2 waveform complex. Analysis indicated a significant decrease in the frequency of impulsive-aggressive outbursts during PHT administration compared to baseline and placebo. Analysis of the psychophysiological data showed significantly increased P1 amplitude and significantly longer N1 latency during PHT administration. In addition, a reduction in N1 amplitude during PHT administration was also suggested. These findings indicate reparation of physiological abnormalities previously observed in impulsive-aggressive individuals and imply more efficient sensory processing and effective orienting of attention. Taken together, these results provide insight as to the physiological mechanisms by which PHT serves to ameliorate impulsive-aggressive behavior.

Keywords: Aggression, Phenytoin, Evoked potentials, P1, N1