Reducing impulsivity in repeat violent offenders using a selective serotonin reuptake inhibitor (sertraline)
University of NSW
460 participants
Oct 21, 2013
Interventional
Conditions
Summary
Violence is a leading cause of death and injury worldwide and a large percentage of prison inmates have histories of violent offending. Numerous studies attest to a strong association between poor impulse control (impulsivity) and violent crime. Impulsivity has been shown to be associated with reduced tone in neural pathways within the brain for which serotonin is the principal neurotransmitter. In a number of studies of impulsive-aggressive individuals, the administration of selective serotonin reuptake inhibitors (SSRIs) has been associated with reduced aggression, impulsivity and depression. To date, there has been no systematic study of the potential benefits of SSRIs for incarcerated impulsive violent offenders who are at high risk of repeat offending. This trial will examine the effectiveness of treatment with an SSRI in impulsive violent offenders on reoffending using a double blind RCT design.
Eligibility
Inclusion Criteria6
- Male sex;
- Over the age of 18 years;
- Prior conviction for 2 or more violent offences;
- Score of 70 or above on the Barratt Impulsiveness Scale;
- Medically fit to undertake the trial;
- Able to provide informed consent.
Exclusion Criteria10
- Current use of any serotonergic drug (e.g. SSRI, SNRI, TCA);
- History of adverse drug reactions to SSRI;
- Current use of any anti-psychotic medication;
- Severe mental illness
- Considered to be at high risk of suicide;
- Anticipation of receiving a custodial sentence;
- Significant renal or hepatic impairment;
- Inability to provide informed consent;
- Conviction for murder or child sexual assault;
- Impending deportation, moving interstate, returning to a remote/inaccessible area.
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Interventions
Intervention consists of 100mg sertraline or placebo sertraline taken orally, once per day for 12 months duration. The medication used in this trial will be in tablet form. Sertraline is an anti-depressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used to treat major depression in adults as well as obsessive-compulsive, panic, and social anxiety disorders in both adults and children. According to the Australian Statistics on Medicines 2007 (latest available data), SSRIs were the most commonly prescribed anti-depressant in Australia with over 8.5 million scripts issued in that year. Among SSRIs, sertraline was the most commonly prescribed anti-depressant. The selected dose is 100mg/day which is common when used as an antidepressant. Sertraline may be prescribed up to 200mg/day.
Locations(1)
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ACTRN12613000442707