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Psychiatry

Disruptive, Impulse-Control, and Conduct Disorders

6 cases on aggression management in ADHD/ASD/ID, conduct disorder, intermittent explosive disorder, and kleptomania pharmacotherapy — choose a case below to open its full multi-voice debate.

PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Adding Risperidone to an Optimized Stimulant for Aggression in ADHD and Oppositional Defiant Disorder

A 9-year-old boy escalates to repeated physical aggression the same week his stimulant finally reaches its optimized dose. The disagreement isn't about whether he needs more help — it's about whether the trial his own treatment is modeled on has actually finished running yet.

Case 0001
PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Risperidone or Aripiprazole for Conduct Disorder in a Teenager of Average Intelligence

A 14-year-old with conduct disorder and no intellectual disability needs an antipsychotic his family can trust. Most of the field's evidence for this drug class was built in a different population — and the two agents on the table don't carry the same kind of evidence at all.

Case 0002
PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Clonidine for Aggression in Conduct Disorder During a Family Move

An 11-year-old's aggression escalates the same month his family relocates for a new job. His parents want to avoid the antipsychotic they researched online — but the trial evidence for the alternative they're asking about was built in children who weren't mid-upheaval.

Case 0003
PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Fluoxetine or Cognitive-Behavioral Therapy First for Intermittent Explosive Disorder

A dental hygienist's escalating workplace outbursts put her job at real, near-term risk. The two treatments with actual trial evidence behind them work on different timelines — and her deadline is shorter than either trial ran.

Case 0004
PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Divalproex or Fluoxetine First-Line for Intermittent Explosive Disorder

A married electrician's explosive rage at home has real evidence behind two very different drugs — and the trial that tested the mood stabilizer's specific value for his exact diagnosis is harder to read than either voice at the table first assumes.

Case 0005
PsychiatryDisruptive, Impulse-Control, and Conduct Disorders
Naltrexone for Kleptomania Ahead of a Court Date

A quilting-circle regular faces a misdemeanor charge over an urge she's fought silently for over a decade. The one real trial behind the drug being offered is smaller, and the dosing further from anything labeled, than almost anywhere else in this project.

Case 0006
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