This section deals with the management of aggressive behaviour through pharmocotherapy. The literature distinguishes between short and long term management of violent behaviour in mentally disordered patients, and refers to inpatient and outpatient programs. These, however, will only be summarized as the main focus of the paper is on psychological interventions. Short term use of psychopharmocologic agents is most often applied in situations where the offender is acting in a seriously threatening manner, towards self or others. The issue is one of control and the medication must have a rapid onset of action.
Intramuscular injection appears to be the preferred intervention.
Choice of medication includes antipsychotic, antianxiety and sedative medications, although each has specific strengths and weaknesses. Monitoring by staff for effects on respiration, blood pressure, pulse rate, and level of consciousness are imperative. Side effects may need to be controlled and toxicological screens should be obtained. Prior treatment experience, substance abuse, and diagnostic precision should inform physicians regarding the appropriate medication. Unlike short term management, then, the aim is more than symptom reduction.