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Review: evidence on the effect of antiepileptics on recurrent aggression inconclusive

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Question

Question:

Do antiepileptic drugs reduce aggression and associated impulsivity?

Outcomes:

Primary outcome: observer or self-reported aggression (Overt Aggression Scale (OAS), modified forms of the OAS (OAS-M, MOAS), self-reported incidents, Children's Psychiatric Rating Scale (CPRS) aggression subscale).

Methods

Design:

Systematic review and meta analysis.

Data sources:

CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, metaRegister of Controlled trials and ClinicalTrials.gov, the Cochrane Schizophrenia Group's register of trials on aggression and the National Research Record were searched in April 2009, and supplemented with a handsearch for studies.

Study selection and analysis:

Placebo controlled randomised controlled trials (RCTs) of any epileptic drug in individuals experiencing recurrent aggressive outbursts or episodes were included, studies in people with dementia were excluded. Three authors independently selected studies and two authors independently extracted data.

Main results

Fourteen placebo controlled RCTs assessing five antiepileptic drugs met inclusion criteria; these studies included 672 participants. The overall quality of the evidence was relatively poor. Twelve studies assessed the primary outcome of aggression for 14 comparisons; meta-analysis was …

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