Intermittent explosive disorder

Episodic Dyscontrol Syndrome or Intermittent Explosive Disorder... 

This syndrome has similarities to the paradoxical reaction seen with barbiturates or BZDs, as well as epileptoid syndromes, including temporal lobe seizures and intermittent explosive disorder. Brain injury from trauma or encephalitis may also predispose some to an abnormally excessive response to even small amounts of alcohol. 

Valproate + fluoxetine II Intermittent explosive disorder + D62 NIMH... 

Selective serotonin reuptake inhibitors (SSRI s) like Prozac are used to treat many psychiatric disorders ranging from intermittent explosive disorder, to obsessive-compulsive disorder, to major depression and panic disorder (1), even though these disorders differ in their behavioral expression. How does one drug class treat these disparate disorders ... 

The treatment of intermittent explosive disorder, kleptomania, pyroma-nia, pathological gambling, trichotillomania, and impulse control disorder not otherwise specified is beyond the scope of this text, and we only briefly discuss some key aspects of impulse control disorders, about which the therapist should seek consultation with the psychiatrist. In particular, one must consider whether the person with intermittent problems of impulse control is manifesting a partial complex seizure (rare), or whether the person who habitually or rhythmically pulls his or her hair has a partial complex seizure instead of trichotillomania (unusual). 

When a therapist is evaluating a patient who demonstrates intermittent loss of impulse control, it is important to look for the sequence of events that kindled the condition. Sometimes, one discovers an obsessional antecedent to the loss of control, and this may respond very well to antiobsessional medication. The woman in the example that follows could have had an intermittent explosive disorder, a personality disorder, or other diagnoses but given her poverty and lack of health care insurance or access, she would probably have received no treatment. Had she been wealthy, she might have received psychotherapy, which may have helped, given time. However, medication management did result in prompt remission of her symptoms, and it may have saved her life and that of her son. In some cases, medication consultation for a patient with one of the impulse control disorders can be a life-saving collaboration between therapist and physician (see case example below). 

The discussion below will focus on the relevance of some of the personality-type characteristics that have been linked to crash involvement. The personality concepts that have been studied in the context of driving include accident proneness, risk taking and sensation seeking, aggression, and perceptual style. Although each of these concepts is described separately, it is important to note that various specific personality characteristics are interrelated. For example, Malta et ol. (2005) demonstrated that aggressive drivers can be characterized by multiple distinct medical disorders such as Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. There are also other personality traits that have been linked to driving and will not be discussed here. These include extroversion (the tendency to attend to external events rather than focus internally) (Smith and Kirkham, 1981) and externally-oriented locus of control (the tendency not to assume responsibility for events that happen to a person) (Mayer and Treat, 1977). 

---