Reducing impulsivity in repeat violent offenders: an open label trial of a selective serotonin reuptake inhibitor

Aust N Z J Psychiatry. 2010 Dec;44(12):1137-43. doi: 10.3109/00048674.2010.525216.


Background: The association between serotonergic dysfunction and aggression has prompted the use of selective serotonin re-uptake inhibitors (SSRIs) as a means of controlling impulsive violent behaviour. The aim of the current study was to examine the feasibility of using an SSRI to treat impulsivity in a group of repeat violent offenders.

Methods: Potential participants were recruited from three magistrates' court complexes in the Sydney metropolitan area and all had histories of violent offending (at least one prior conviction for a violent offence). Those who scored highly on the Barratt Impulsivity Scale (BIS-11), passed medical and psychiatric evaluations and consented to treatment were prescribed sertraline (Zoloft) over a three month period.

Results: Thirty-four individuals commenced the trial, with 20 completing the three month intervention. Reductions were observed across a range of behavioural measures from baseline to 3 months: impulsivity (35%), irritability (45%), anger (63%), assault (51%), verbal-assault (40%), indirect-assault (63%), and depression (62%). All those who completed the three month trial requested to continue sertraline under the supervision of their own medical practitioner.

Conclusion: Our findings suggest that treating impulsive violent individuals in the criminal justice system with an SSRI is a potential treatment opportunity for this population. An adequately powered randomized control trial of this intervention is warranted.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aggression / drug effects*
  • Aggression / psychology*
  • Anger / drug effects
  • Criminals / psychology*
  • Depression / drug therapy
  • Humans
  • Impulsive Behavior / complications
  • Impulsive Behavior / drug therapy*
  • Impulsive Behavior / psychology*
  • Irritable Mood / drug effects
  • Male
  • Patient Compliance / statistics & numerical data
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Violence / psychology


  • Serotonin Uptake Inhibitors
  • Sertraline