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

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Do antiepileptic drugs reduce aggression and associated impulsivity?


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).



Systematic review and meta analysis.

Data sources:

CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, metaRegister of Controlled trials and, 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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  • Sources of funding Nottingham Healthcare NHS trust, NHS Cochrane Collaboration Programme Grant Scheme, UK.


  • Competing interests SZ is a consultant for Alexza Pharamceuticals and a member of the Speakers Bureau for Eli Lilly and Pfizer.

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