Trazodone for aggression in an adolescent with hydrocephalus

Abstract A case of 19 year old male with hydrocephalus is reported whose aggressive self-injurious behaviors were resistant to conventional pharmacotherapy but successfully treated by trazodone. In addition to the self-injurious behaviors, this patient displayed withdrawal and eating refusal, which initially resulted in his admission to a psychiatric ward. Various conventional treatments with pharmacotherapy (e.g., tricyclic antidepressants, antipsychotics, anxiolytics and anticonvulsants) in combination with psychotherapy and family therapy proved not to be effective for 15 months. Neither was electroconvulsive therapy successful. Administration of trazodone for 5 months after tapering of the above agents improved his aggressive behaviors. A survey of previous cases with organic brain syndromes who had aggressive behaviors and responded well to trazodone revealed that most of the cases were aged individuals and that cases in adolescence are rare.