Typical and atypical antipsychotic use in aggressive children and adolescents: a systematic review

Aggression is a transnosographic dimension of many psychiatric disorders. According to their aims and manifestations, aggressive behaviours may be considered as adaptive (defensive aggression) or maladaptive (impulsive and proactive pathological aggression). The specific neurobiological mechanisms underlying aggression haven't been clarified yet. Aggression and impulsivity seem to be influenced by the unbalance between serotonin inhibitory action and dopamine activating action on behaviour. Pharmacological treatment of aggressive behaviours consist in acute and preventive, long-term interventions. Typical and atypical antipsychotics, benzodiazepines, mood stabilizers, beta-blockers and SSRI, entered in mono-therapy or in combination, are the most frequently used medications. The object of our study is to review, analyzing scientific literature, the use of typical and atypical antipsychotics for the treatment of aggression in children and adolescents.