Intermittent Explosive Disorder

The exact cause of intermittent explosive disorder is not known. Some evidence suggests there may be a link between this disorder and mild neurological problems similar to those associated with some learning disabilities.

A person who has intermittent explosive disorder:

• destroys property
• has repeated acts of sudden verbal or physical aggression
• is unable to stop or control the impulsive, aggressive actions

A person who has this disorder is not violent or aggressive most of the time. The outbreaks of severe rage and anger are usually isolated. The amount of aggression is out of proportion with the incident that triggered the outburst.

The cause of intermittent explosive disorder is not known. It may be caused by an abnormality in the nervous system. Things that increase a person's risk for the disorder include:

• a caregiver who is antisocial
• child abuse and neglect
• conflict with a spouse or significant other
• parents who abuse drugs or alcohol
• lower socioeconomic status
• parents who are not consistent in their availability or discipline
• psychiatric illness

To be diagnosed with this disorder, an individual must have had at least three episodes in his or her life where he or she lost control and committed an act of destruction, completely out of proportion to any provocation that may have occurred. Evaluation of intermittent explosive disorder begins with a medical history and physical exam. A complete psychological evaluation should be done to rule out another medical or mental disorder.

Someone who has intermittent explosive disorder may have social or legal problems as a result of the aggressive behavior. The behavior may also cause problems at home or school.

Intermittent explosive disorder is not contagious.

A combination of medication and psychological treatment is generally used to treat this disorder. A wide variety of medications have been used, including antidepressants such as fluoxetine (i.e., Prozac, Sarafem), antipsychotics, anti-anxiety agents, and anticonvulsants such as phenytoin (i.e., Dilantin). Psychotherapy with a focus on awareness of appropriate limits in social settings is often helpful.

Side effects of medicines vary. They may include allergic reactions and drowsiness.

With effective treatment, the person can live a normal life.

Any new or worsening symptoms should be reported to the healthcare professional.