Allopurinol for the Treatment of Refractory Aggression: A Case Series

Abstract

Objective: Allopurinol is a drug indicated for the treatment and prevention of gout. Through various theorized mechanisms, there has been an observed benefit in reducing aggression in patients with dementia who are refractory to traditional interventions. This case series of eight patients reports the use of allopurinol to treat aggression at the Battle Creek Veterans Affairs Medical Center.

Methods: Charts of research participants were accessed retrospectively to obtain data. Adverse event notes were evaluated to identify the number of aggressive events before the initiation of allopurinol compared with the total number and rates of aggressive events after the initiation of allopurinol.

Results: A total of eight patients were included in the case series. Of those started on allopurinol for treating aggression, two showed no effect while all other participants responded with a decrease in the number and rate of reported aggressive episodes.

Conclusions: Allopurinol was observed to decrease the number and rate of aggressive events in patients refractory to other treatments.

Keywords: aggression; allopurinol; dementia; schizoaffective; schizophrenia.