Anger Management Drugs

Anger Management Drugs don’t really exist! The usual medication prescribed to help anger are antidepressants. However please read my page on anger management medication for more general information. On this page I have listed some common antidepressants used also as Anger Management Drugs, including vital information. Please use this as a rough guide as it may go out of date. Don’t use it as a guide on how much medicine to take. Always consult your physician first.

Here are the SSRIs approved by the Food and Drug Administration (FDA) specifically to treat depression, with their generic, or chemical, names followed by available brand names in parentheses:

Citalopram

Note these drugs are antidepressants rather than Anger Management Drugs per se. There are no such thing as Anger Management Drugs that directly target anger.

GENERIC NAME: citalopram
BRAND NAME: Celexa
DRUG CLASS AND MECHANISM: Citalopram is an antidepressant medication that affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by citalopram results in more free serotonin in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors(SSRIs), a class that also contains fluoxetine (Prozac), paroxetine (Paxil) and sertraline(Zoloft). Citalopram was approved by the FDA in July 1998.
GENERIC AVAILABLE: Yes
PRESCRIPTION: Yes
PREPARATIONS: Tablets: 10, 20, and 40 mg. Solution: 10 mg/5 ml
STORAGE: Citalopram should be stored at room temperature, 15 to 30 C (59 to 86 F).
PRESCRIBED FOR: Citalopram is used for the management of depression. Citalopram also is used for treating obsessive compulsive disorder (OCD), panic disorder,premenstrual dysphoric syndrome (PMDD), anxiety disorder, and posttraumatic stress disorder.
DOSING: The usual starting dose is 20 mg in the morning or evening. The dose may be increased to 40 mg daily after one week. A dose of 60 mg has not been shown to be more effective than 40 mg. As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often slowly adjusted upwards to find the most effective dose.
DRUG INTERACTIONS: All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline(Eldepryl), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started. Tryptophan, a common dietary supplement, can causeheadaches, nausea, sweating, and dizziness when taken with any SSRI.Use of an SSRI with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.
PREGNANCY: Exposure of neonates to citalopram in the third trimester may cause complications.
NURSING MOTHERS: Citalopram is excreted in breast milk. Breastfeeding by a citalopram treated woman may cause adverse effects in the infant.
SIDE EFFECTS: The most common side effects associated with citalopram are nausea,dry mouth, vomiting, excessive sweating, headache, tremor, drowsiness, and inability tosleep. Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Citalopram is also associated with sexual dysfunction. Some patients may experience withdrawal reactions upon stopping citalopram. Symptoms of withdrawal include dizziness, tingling sensations, tiredness, vivid dreams, and irritability or poor mood.Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Escitalopram

Note these drugs are antidepressants rather than Anger Management Drugs per se. There are no such thing as Anger Management Drugs that directly target anger.

GENERIC NAME: escitalopram
BRAND NAME: Lexapro
DRUG CLASS AND MECHANISM: Escitalopram is an oral drug that is used for treatingdepression and generalized anxiety disorder. Chemically, escitalopram is similar tocitalopram (Celexa). Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) andsertraline (Zoloft). SSRIs work by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Some neurotransmitters that are released do not bind to receptors and are taken up by the nerves that produced them. This is referred to as “reuptake.” Many experts believe that an imbalance of neurotransmitters is the cause of depression. Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by nerves, an action which results in more serotonin in the brain to attach to receptors. The FDA approved escitalopram in August 2002.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 5, 10, and 20 mg. Solution: 1 mg/ml
STORAGE: Escitalopram should be stored at room temperature, 15-30 C (59-86 F)
PRESCRIBED FOR: Escitalopram is approved for the treatment of depression and generalized anxiety disorder. Drugs in the SSRI class also have been studied in persons with obsessive compulsive disorders and panic disorders, but escitalopram is not approved for this purpose.DOSING: The usual starting dose of escitalopram is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 1 week. Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be anymore effective than 10 mg daily for treatment of depression. Escitalopram can be taken with or without food.
DRUG INTERACTIONS: All SSRIs, including escitalopram, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline(Eldepryl) and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing escitalopram before starting an MAO inhibitor. Conversely, at least 14 days should elapse after discontinuing an MAO inhibitor before starting escitalopram.Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI.Use of selective serotonin inhibitors may increase the risk of gastrointestinal bleeding in patients taking aspirin, nonsteroidal antiinflammatory drugs, and other drugs that cause bleeding.
PREGNANCY: The safety of escitalopram during pregnancy and breastfeeding has not been established. Therefore, escitalopram should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to the patient outweigh unknown hazards to the fetus.
NURSING MOTHERS: Escitalopram is excreted in human milk. Escitalopram should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.SIDE EFFECTS: The most common side effects associated with escitalopram are agitation or restlessness, blurred vision, diarrhea, difficulty sleeping, drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, increased or decreased appetite, increased sweating, sexual difficulties (decreased sexual ability or desire, ejaculatory delay), taste alterations, tremor (shaking), weight changes. Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given escitalopram report difficulties ejaculating.Some patients experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include dizziness, tingling, tiredness, vivid dreams, irritability, or poor mood. In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of escitalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond 24 years of age. There was a reduction in risk of suicidality with antidepressants compared with placebo in adults 65 years of age and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients who are started on therapy with antidepressants should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.

Fluoxetine

Note these drugs are antidepressants rather than Anger Management Drugs per se. There are no such thing as Anger Management Drugs that directly target anger.

GENERIC NAME: fluoxetine
BRAND NAME: Prozac, Serafem
DRUG CLASS AND MECHANISM: Fluoxetine is an oral drug that is used for treatingdepression. It is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains citalopram (Celexa), paroxetine (Paxil) and sertraline(Zoloft). Fluoxetine affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Serotonin is one neurotransmitter that is released by nerves in the brain. The serotonin either travels across the space between nerves and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it, to be taken up by the nerve and released again (a process referred to as re-uptake).Many experts believe that an imbalance among neurotransmitters is the cause of depression. Fluoxetine works by preventing the reuptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by fluoxetine increases free serotonin that stimulates nerve cells in the brain. The FDA approved Fluoxetine in December 1987.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 10, 20, and 40 mg. Capsules (delayed release): 90 mg. Tablets: 10, 15, and 20 mg. Oral suspension: 20mg/5ml
STORAGE: Fluoxetine should be stored at room temperature 15-30 C (59-86 F).
PRESCRIBED FOR: Fluoxetine is used for treating depression, bulimia, obsessive-compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder(PMDD). It also is used in combination with olanzapine (Zyprexa) for treatment of resistant depression and treatment of depression associated with bipolar disorder.
DOSING: Depression in adults is treated with 20-80 mg of fluoxetine daily. The recommended dose for treating depression in children is 10-20 mg daily. After 13 weeks of daily administration, once weekly dosing may be effective in some patients.Bulimia is treated with 60 mg of fluoxetine daily. Long-term treatment for up to 52 weeks has been shown to be beneficial in maintaining remission.Obsessive-compulsive disorder in adults and children is treated with 20-60 mg daily and panic disorder is managed with 10-60 mg daily. The recommended regimen for PMDD is 20 mg administered every day of the menstrual cycle or daily for 14 days prior to the onset of menstruation through the first day of menses.The recommended treatment for resistant depression is 20-50 mg of fluoxetine and 5-20 mg olanzapine once daily in the evening while the recommended treatment for depression associated with bipolar disorder is 20-50 mg fluoxetine and 5-12.5 mg olanzapine once daily in the evening
DRUG INTERACTIONS: Fluoxetine should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants [for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine(Matulane)] or other drugs that inhibit monoamine oxidase [for example, linezolid(Zyvox)]. Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Fluoxetine should not be administered for at least 14 days after stopping MAOIs. Because fluoxetine is active in the body for several weeks, MAOIs should not be administered for at least 5 weeks after fluoxetine has been stopped. Similar reactions occur when fluoxetine is combined with other drugs, for example, tryptophan, St. John’s wort, meperidine (Demerol), and tramadol (Ultram) that increase serotonin in the brain.Fluoxetine may increase the effect of warfarin (Coumadin), leading to excessive bleeding. Warfarin therapy should be monitored more frequently in patients who are also taking fluoxetine. Combining SSRIs with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.
PREGNANCY: Use of fluoxetine during the third trimester of pregnancy may lead to adverse effects in the newborn.
NURSING MOTHERS: Fluoxetine is excreted in breast milk. Therefore, taking fluoxetine while nursing is not recommended.

Paroxetine

Note these drugs are antidepressants rather than Anger Management Drugs per se. There are no such thing as Anger Management Drugs that directly target anger.

GENERIC NAME: paroxetine
BRAND NAME: Paxil, Paxil CR, Pexeva
DRUG CLASS AND MECHANISM: Paroxetine is an oral drug that is used for treatingdepression. It is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also contains fluoxetine (Prozac), citalopram (Celexa), andsertraline (Zoloft). Paroxetine affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Serotonin is oneneurotransmitter that is released by nerves in the brain. The serotonin either travels across the space that lies between nerves and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it, to be taken up by the nerve and released again (a process referred to as re-uptake).Many experts believe that an imbalance among neurotransmitters is the cause of depression. Paroxetine works by preventing the reuptake of one neurotransmitter, serotonin, by nerve cells after it has been released. Since reuptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by paroxetine increases free serotonin that stimulates nerve cells in the brain. The FDA approved paroxetine in December 1992.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 20, 30, and 40 mg; Paxil CR Tablets: 12.5, 25, and 37.5 mg; Suspension: 10 mg/5ml
STORAGE: Tablets should be kept at room temperature, 59-86 F (15- 30 C). The suspension and controlled release tablets should be stored at or below 77 F (25 C).
PRESCRIBED FOR: Paroxetine is used for the management of depression, obsessive-compulsive disorders (OCD), panic disorders, post traumatic stress disorder (PTSD),premenstrual dysphoric disorder (PMDD), and social anxiety disorder.
DOSING: The recommended dose is 20-60 mg daily of immediate release tablets or 12.5-75 mg daily using controlled release tablets. Paroxetine is given as a single daily dose, usually in the morning. As with all anti-depressants, the full effect may not occur until after a few weeks of therapy. Doses for obsessive-compulsive disorders and panic disorders are often higher than those for depression. Doses often are adjusted to find the optimal dose. Elderly patients, debilitated persons, and patients with certain kidneyor liver diseases may need lower doses because they metabolize and eliminate paroxetine more slowly and, therefore, are prone to develop high blood levels andtoxicity.
DRUG INTERACTIONS: All SSRIs, including paroxetine, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline(Eldepryl, Carbex), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between paroxetine and MAOIs.) Similar reactions occur when paroxetine is combined with other drugs [for example, tryptophan,St. John’s wort, meperidine (Demerol), tramadol (Ultram) that increase serotonin in the brain.Paroxetine may increase the effect of the blood thinner, warfarin (Coumadin), leading to excessive bleeding. Therefore, warfarin therapy should be monitored more frequently in patients who are also taking paroxetine. Combining SSRIs such as paroxetine with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding. Phenytoin (Dilantin) and phenobarbital may decrease the amount of paroxetine in the body and possibly reduce its effectiveness.
PREGNANCY: Use of paroxetine during pregnancy may result in congenital heart defects. Paroxetine should not be administered to pregnant women unless the need justifies the risk.

Sertraline

Note these drugs are antidepressants rather than Anger Management Drugs per se. There are no such thing as Anger Management Drugs that directly target anger.

GENERIC NAME: sertraline
BRAND NAME: Zoloft
DRUG CLASS AND MECHANISM: Sertraline belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Other drugs in this class are Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram) and Luvox (fluvoxamine). Serotonin is a neurotransmitter (a chemical messenger) produced by nerve cells in the brain that is used by the nerves to communicate with one another. A nerve releases the serotonin it produces into the space surrounding it. The serotonin either travels across the space and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it, to be taken up by the nerve and released again (a process referred to as re-uptake). A balance is reached for serotonin between attachment to the nearby nerves and reuptake. Selective serotonin inhibitors block the reuptake of serotonin and therefore change the level of serotonin in the brain.It is believed that some illnesses such as depression are caused by disturbances in the balance between serotonin and other neurotransmitters. The leading theory is that drugs such as sertraline restore the chemical balance among neurotransmitters in the brain. The FDA approved sertraline in December 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50, and 100 mg; oral concentrate: 20 mg/ml
STORAGE: Sertraline should be stored at room temperature between 15-30 C (59-86 F).
PRESCRIBED FOR: Sertraline is used for treating depression, obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). Sertraline also is used for treating social anxiety disorder and postmenstrual dysphoric disorder(PMDD).DOSING: The recommended dose of sertraline is 25-200 mg once daily. Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25-50 mg once daily. Doses are increased at weekly intervals until the desired response is seen.The recommended dose for PMDD is 50-150 mg every day of the menstrual cycle or for 14 days before menstruation.Sertraline may be taken with or without food.
DRUG INTERACTIONS: Serious reactions such as hyperthermia, fluctuations in blood pressure and rigidity of muscles may occur when SSRIs are used in combination with monoamine oxidase inhibitors (MAOI) such as phenelzine, tranylcypromine (Parnate) and isocarboxazid. Therefore, SSRIs should not be used in combination with MAOIs. In addition, SSRIs and MAOIs should not be used within 14 days of each other.Cimetidine (Tagamet) may increase the levels in blood of sertraline by reducing the elimination of sertraline by the liver. Increased levels of sertraline may lead to more side effects.Sertraline increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and sertraline.Through unknown mechanisms, sertraline may increase the blood thinning action ofwarfarin (Coumadin). The effect of warfarin should be monitored when sertraline is started or stopped.
PREGNANCY: Use of sertraline during the 3rd trimester of pregnancy may lead to adverse effects in the newborn.
NURSING MOTHERS: Use of sertraline by nursing mothers has not been adequately evaluated.
SIDE EFFECTS: The most common side effects of sertraline are sleepiness, nervousness, insomnia, dizziness, nausea, tremor, skin rash, upset stomach, loss of appetite, headache, diarrhea, abnormal ejaculation, dry mouth and weight loss. Important side effects are irregular heartbeats, allergic reactions and activation of mania in patients with bipolar disorder.If sertraline is discontinued abruptly, some patients experience symptoms such as abdominal cramps, flu like symptoms, fatigue and memory impairment. Although this reaction is not well established, it is reasonable to gradually reduce the dose of sertraline when therapy is discontinued.Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of sertraline or any other antidepressant in a child or adolescent must balance this risk with the clinical need for the antidepressant. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.