Violent behavior, including different types of abuse and physical attacks, is a huge problem in human relationships. However, relying on simple persuasion or even behavioral psychotherapy can often be ineffective or overly demanding approaches. Therefore, it is crucial to consider a potentially faster and more effective approach of medication-assisted therapy for violent behavior.

It is known that humans have a violence inhibition mechanism, which causes them to experience an aversive reaction to harming other people. The serotonergic system of the brain is responsible for this mechanism and the regulation of aggression in general^[1][2]. Therefore, it is reasonable to conclude that the most effective therapy for violent behavior should focus on restoring its healthy functioning. And now, we will offer a number of medications that can help people who are prone to committing violence.

Before considering more serious solutions, we should look into the use of common bioactive supplements or natural remedies. For example, tryptophan, a serotonin precursor, may be a good option. The recommended dosage is 500 milligrams per day. Single doses of up to 10 grams have been used in experiments, and in some cases, it significantly reduced aggression and increased generosity in people^[3]. Multiple studies have found that “omega-3” supplementation leads to a moderate reduction in aggression, and this may be due to improvements in the violence inhibitor function^[4][5]. Mixtures of herbal extracts like Kamishoyosan (also known as Jia Wei Xiao Yao San in Chinese) and Yokukansan (or even just its specific ingredient, Uncaria rhynchophylla extract; not to be confused with the more common Uncaria tomentosa), as shown in animal studies, may also have an anti-aggressive effect by affecting the serotonergic system^[6][7]. In the case of these remedies, taking them daily at the dosage recommended by the manufacturer of the particular product should be sufficient.

Based on numerous animal experiments and limited human trials, it is believed that drugs activating specific receptors (1A and 1B) of the serotonergic system should be very effective and selective (with no side effects and no disruption of any behaviors other than offensive aggression)^[8][9]. Such agents include the previously mentioned mixtures of herbal extracts. Among the widely available drugs with this mechanism of action are triptans, commonly used against migraine. Particularly noteworthy is zolmitriptan, which was successful in reducing aggression in mice and attenuating alcohol-heightened aggression in humans (using only 5 milligrams of the medication; however, given its safety, it is possible to increase the dosage if necessary)^[10][11]. Researchers have also proposed testing triptans, specifically a 4-week course of naratriptan, on violent offenders^[12].

We should not overlook the use of classic antidepressants, selective serotonin reuptake inhibitors (SSRIs), which lead to a general increase of serotonin in the brain. Despite their frequent side effects, researchers have tested these drugs more than others for their anti-aggressive effect when administered to humans. For example, individuals with personality disorders who take fluoxetine are 4 times less likely to engage in aggressive behavior than those who do not take SSRIs^[13]. A daily intake of 20–60 milligrams of fluoxetine can reduce aggressiveness to a certain extent after 4 weeks, and after 10 weeks, there are significant improvements^[14]. In laboratory tests, a single dose of 40 milligrams of paroxetine successfully eliminated aggression associated with primary psychopathy (the typical traits of which are callousness and lack of empathy; these traits are strongly associated with violence inhibitor dysfunction)^[15]. Finally, taking 30–40 milligrams of fluoxetine daily for 12 weeks significantly reduced the propensity for both physical and nonphysical aggression in people with alcoholism who were violent toward their spouses or significant others^[16].

Among SSRIs, vortioxetine (most commonly sold under the brand names Brintellix and Trintellix) is particularly noteworthy. Although, due to its novelty, it has not yet been widely tested for its anti-aggressive effect (however, there are already studies on single patients), because of its multimodal mechanism of action, including action on serotonin 1A and 1B receptors, this drug is considered to have a great potential in the treatment of pathological expressions of aggression and to be safer and more effective than other SSRIs^{[17][18][19][20]}.

In addition to all of the above, it is not unreasonable to consider such an approach to the treatment of violent behavior as inhalation of essential oil vapors. These often contain linalool, which acts on serotonin 1A receptors and has been shown to have an anti-aggressive effect in animal experiments^[21][22]. Many essential oils (bitter orange, neroli, petitgrain, rose, lavender, citronella, etc.) have substances with similar mechanisms of action (including the already mentioned linalool, as well as d-limonene, citronellol, etc.)^{[23][24][25][26][27]}.

Taking probiotics can be potentially beneficial (these include Bifidobacterium breve and longum, Lactobacillus plantarum, lactis, and rhamnosus). They can increase tryptophan and serotonin levels in the organism, as well as influence the serotonergic system of the brain through the gut-brain axis^{[28][29][30][31][32][33]}. It may be best to use complexes that include various probiotics at once.

When using any of these medications, it is important to carefully select dosages and take into account possible side effects; if any of them are present, it is necessary to stop taking the medication that caused them immediately! But if everything is done correctly, you can expect a positive result, consisting in the improvement of the behavior of a person who previously actively harmed and even attacked other people by correcting the deficit in the violence inhibition mechanism.

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