What medications best treat Intermittent Explosive Disorder?  

Anecdotally (based on my experiences only), anything and nothing. It appears to be an intellectual/cognitive issue and most often a symptom of a wider pathology e.g., a history of trauma. Pharmacological treatments therefore seem only partially effective at best. With PTSD as the most common parent...

There is data that clonidine can help with impulsivity, irritability, and hyper-arousability (along with ADHD), and I have found this medication to be very useful in people with intellectual disability who are hyper-arousable, with many of them having been labeled as having intermittent explosive di...

Fluoxetine has placebo-controlled trials that demonstrate its efficacy in IEDs. There are case reports suggesting efficacy for other SSRIs. Doses of 20-40 mg have been shown to be effective.

As a child and adolescent psychiatrist, my answer will have a different slant. Many of the children/teens with intermittent explosive symptoms I treat have comorbid ADHD. I have had success with using stimulants and some success with alpha-agonists like clonidine or guanfacine. In more extreme situa...

I have had good experience with 100 mg of lamotrigine daily.

As a child and adolescent psychiatrist, I never diagnose IED. Temper/mood outbursts are a clinical symptom, not a diagnosis in and of themselves. The goal is to discern the underlying pathology - ODD? DMDD? ADHD? ASD? Trauma? Treating the underlying pathology is the goal. Experts have likened temper...

I agree that there is a co-morbid disorder that requires treatment, either or both pharmacological and psychotherapeutic. However, there is often an urgency, calling for a rapid pharmacologic intervention. I have used clonidine, beta-blockers, valproate, and low-dose antipsychotics, depending on the...

I also use clonidine a lot, for general anxiety. Intermittent explosive disorder is often caused by complex post-traumatic stress disorder; abuse in childhood. I find lamotrigine to be extremely helpful. As an anticonvulsant, it addresses the seizure-like properties of explosive episodes. They ...

Isn't the tough part the differential diagnosis? ADHD, PTSD, CTE, Epilepsy, Steroid Treatment, Premenstrual Dysphoric Disorder, Pediatric Autoimmune Disorder Associated with Strep, Fetal Drug Exposure, etc. It seems in my experience that there is a heavy neurobiological element in the presentation o...

I work in prisons with male inmates, and the vast majority of what I see is character pathology, largely ASPD or Borderline PD, but you could make a case that a lot of my patients met criteria for IED in the past as well. I can't say I have found one treatment superior to others. I tend to approach ...