Skip to main content
SpringerLink
Log in

Lithium for irritability in Post-Traumatic stress disorder

  • Brief Report
  • Published:
Journal of Traumatic Stress

Abstract

Irritability is often a problem for patients with Post-Traumatic Stress Disorder (PTSD). We describe two cases that illustrate the use of lithium in the treatment of veterans with PTSD who complained of serious problems with irritability or angry outbursts. These cases are discussed in the context of evidence that lithium may be useful in other patients with disorders of impulse control. The evidence linking disorders of anger and impulse control to a dysregulation in neurotransmitter regulation, particularly in serotonergic pathways, supports a psychopharmacologic approach to treatment. These findings should lead to further study of the role of lithium in the treatment of this symptom complex in patients with PTSD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Abou-Saleh, M. T. (1992). Lithium. In E. S. Paykel (Ed.),Handbook of affective disorders (2nd ed.) (pp. 369–385). New York, Guilford Press.

    Google Scholar 

  • Campbell, M., Small, A. M., Green, W. H., Jennings, S. J. Perry, R., Bennett, W. G., & Anderson, L. (1984). Behavioral efficacy of haloperidol and lithium carbonate: a comparison in hospitalized aggressive children with conduct disorder.Archives of General Psychiatry, 41 650–656.

    PubMed  Google Scholar 

  • Di Chiara, G., Camba, R., & Spano, P. F. (1971). Evidence for inhibition by brain serotonin of mouse killing behavior in rats.Nature 233 272–273.

    Article  PubMed  Google Scholar 

  • Eichelman, B. (1988). Toward a rational pharmacotherapy for aggressive and violent behavior.Hospital and Community Psychiatry 39 31–39.

    PubMed  Google Scholar 

  • Faustman, W. O., & White, P. A. (1989). Diagnostic and pharmacologic treatment characteristics of 536 inpatients with post-traumatic stress disorder.Journal of Nervous and Mental Disease, 177 154–159.

    PubMed  Google Scholar 

  • Feldman, T. B. (1987). Alprazolam in the treatment of post-traumatic stress disorder.Journal of Clinical Psychiatry, 48 216–217.

    Google Scholar 

  • Fesler, A. F. (1991). Valproate in combat-related post-traumatic stress disorder.Journal of Clinical Psychiatry, 52 361–364.

    PubMed  Google Scholar 

  • Fishbein, D. H., Zovsky, D., & Jaffe, J. H. (1989). Impulsivity, aggression and neuroendocrine responses to serotonergic stimulation in substance abusers.Biological Psychiatry, 25 1049–1066.

    Article  PubMed  Google Scholar 

  • Frank, J. B., Kosten, T. R., Giller, E. L., & Dan, J. E. (1988). A randomized clinical trial of phenelzine and imipramine for post-traumatic stress disorder.American Journal of Psychiatry, 145 1289–1291.

    Google Scholar 

  • Friedman, M. J. (1988). Toward rational pharmacotherapy for post-traumatic stress disorder: An interim report.American Journal of Psychiatry, 145 281–285.

    Google Scholar 

  • Jacobs, B. L., & Cohen, A. (1976). Differential behavioral effects of lesions of the median or dorsal raphe nuclei in rats: Open field and pain-elicited aggression.Comparative and Physiological Psychology, 90 102–108.

    Google Scholar 

  • Jenkins, S. C., & Maruta, T. (1987). Therapeutic use of propranolol for intermittent explosive disorder.Mayo Clinic Proceedings 67 204–214.

    Google Scholar 

  • Jordan, B. K., Marmar, C. R., Fairbank, J. A., Schlenger, W. W., Kulka, R. A., & Weiss, D. S. (1992). Problems in families of male Vietnam veterans with post-traumatic stress disorder.Journal of Consulting and Clinical Psychology, 60(6), 916–926.

    Article  PubMed  Google Scholar 

  • Kantak, K. M., Hegstrand, L. R., & Eichelman, B. (1981). Facilitation of shock-induced fighting following intraventricular 5,7-dihydroxytryptamine and 6-hyrdoxydopa.Psychopharmacology, 74 157–160.

    Article  PubMed  Google Scholar 

  • Kantak, K. M., Hegstrand, L. R., Whitman, J., & Eichelman, B. (1980). Effects of dietary supplements and a tryptophan-free diet on aggressive behavior in rats.Pharmacology, Biochemistry, and Behavior, 12 173–179.

    Google Scholar 

  • Kitchner, I., & Greenstein, R. (1987). Low dose lithium carbonate in the treatment of post-traumatic stress disorder.Military Medicine, 150 378–381.

    Google Scholar 

  • Kolb, L. C., Burris, B. C., & Griffiths, S. (1984). Propranolol and clonidine in treatment of post-traumatic stress disorders. In van der Kolk (Ed.),Post-traumatic stress disorder: Psychological and biological sequelae (pp. 98–105). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Kruesi, M. J. P., Rapoport, J. L., Hamburger, S., Hibbs, E., Potter, W. Z., Lenane, M., & Brown, G. L. (1990). CSF monamine metabolites, aggression and impulsivity in disruptive behavior disorders of children and adolescents.Archives of General Psychiatry, 47 419–426.

    PubMed  Google Scholar 

  • Lipper, S., Davidson, J. R. T., Grady, J. D., & Edinger, J. D. (1986). Preliminary study of carbemazepine in post-traumatic stress disorder.Psychosomatics, 27 849–853.

    Google Scholar 

  • Mattes, J. A., Rosenberg, J., & Mays, D. (1984). Carbamazepine versus propranolol in patients with ucontrolled rage outbursts: a random assignment study.Psychopharmacology Bulletin, 20 98–100.

    PubMed  Google Scholar 

  • Meltzer, H. Y. (1984). Serotonergic function in the affective disorders: The effect of antidepressants and lithium on the 5-hydroxytryptophan-induced increase in serum cortisol (Review).Annals of the New York Academy of Sciences, 430 115–137.

    PubMed  Google Scholar 

  • Morand, C., & Young, S. N. (1983). Clinical response of aggressive schizophrenics to oral tryptophan.Biological Psychiatry, 18 575–578.

    PubMed  Google Scholar 

  • Perez-Cruet, J., Tagliamonte, A., & Gessa, G. L. (1971). Stimulation of serotonin synthesis by lithium.Pharmacology and Experimental Therapeutics 178 325–330.

    Google Scholar 

  • Price, L. H., Charney, D. S., Delgado, P. L., & Heninger, G. R. (1990). Lithium and serotonin function: Implications for the serotonin hypothesis of depression.Neurosciences and Behavior, 100 3–12.

    Google Scholar 

  • Shader, R. I., Jackson, A. H., & Dodes, L. M. (1974). The antiaggressive effects of lithium in man.Psychopharmacologia, 40 17–24.

    Article  PubMed  Google Scholar 

  • Shay, J. O. (1992). Fluoxetine reduces explosiveness and elevates mood of Vietnam combat vets with PTSD.Journal of Traumatic Stress, 5 97–101.

    Article  Google Scholar 

  • Sheard, M. H., Marini, J. L., Bridges, C. I., & Wagner, E. (1976). The effect of lithium on impulsive aggressive behavior in man.American Journal of Psychiatry, 133 1409–1413.

    PubMed  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Avitzur, E. (1988). Coping, locus of control, social support, and combat-related post-traumatic stress disorder: A prospective study.Personality and Social Psychology Bulletin, 55 279–285.

    Article  Google Scholar 

  • Tupin, J. P., Smith, D. B., Clanon, T. L., Kim, L. I., Nugent, A., & Groupe, A. (1973). The long-term use of lithium in aggressive prisoners.Comprehensive Psychiatry 14 311–317.

    Article  PubMed  Google Scholar 

  • van der Kolk, B. (1987). The drug treatment of post-traumatic stress disorder.Affective Disorders, 13 203–213.

    Article  Google Scholar 

  • van Praag, H. (1989). The role of serotonergic mechanisms in aggression, auto aggression and impulse control-induction.Neurosciences and Behavior, 13(S), 1.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. San Francisco General Hospital, University of California, San Francisco Medical Director, Psychiatric Emergency Services, 1001 Potrero Street, 94110, San Francisco, California

    Peter L. Forster (Assistant Clinical Professor of Psychiatry), Frank B. Schoenfeld (Associate Clinical Professor of Psychiatry) & Charles R. Marmar (Associate Professor of Psychiatry)

  2. Department of Veterans Affairs Medical Center, 4150 Clement Street, 94121, San Francisco, California

    Frank B. Schoenfeld (Associate Clinical Professor of Psychiatry) & Charles R. Marmar (Associate Professor of Psychiatry)

Authors
  1. Peter L. Forster
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank B. Schoenfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charles R. Marmar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ariel Janna Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Forster, P.L., Schoenfeld, F.B., Marmar, C.R. et al. Lithium for irritability in Post-Traumatic stress disorder. J Trauma Stress 8, 143–149 (1995). https://doi.org/10.1007/BF02105412

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02105412

Key words

Search

Navigation