Is there a medication for stress and anger

Deborah C. Escalante

Key takeaways:

  • Anger is a natural feeling that everyone experiences from time to time. But sometimes it can become concerning or be a symptom of an underlying health condition.

  • If you have trouble managing your anger, it’s recommended to talk to your healthcare provider. They help you find ways to manage or redirect your anger — with or without medications. 

  • Many medications used for anger treatment are available as lower-cost generic medications. For example, for a 30-day supply of sertraline (Zoloft), a common antidepressant medication, you may be able to pay as low as $7 with GoodRx.

Couple arguing at home. Both are using their hands in expressive motions.urbazon/E+ via Getty Images

Anger can be a difficult emotion to manage. To some degree, everyone experiences stress and life events that lead to feelings of anger. But what happens when you realize your feelings of anger might be out of the ordinary, or you find yourself unable to control your anger?

There are several different types of treatments that might help with anger, such as therapy, relaxation techniques, and counseling. Medications are another option to consider when needed, but they’re not always go-to options. You’ll need to talk to your healthcare provider to determine which course of treatment is right for you.

What are the best treatment options for anger?

There are many ways to help treat or control anger. It all depends on the person, symptoms, and underlying causes.

In general, medications aren’t top treatment choices for anger, even if it feels overwhelming or frequent. Controlling and managing anger without medication is preferred when possible. 

Your healthcare provider can tell you about several ways to help control anger without medications. In many cases, cognitive behavioral therapy (CBT) is one of these recommended tools. CBT helps you focus on your mindfulness and managing your emotions. Other coping skills — like listening to music, deep breathing exercises, and journaling — may also help promote feelings of calm. 

However, medications can still help in certain situations. This is especially true if other treatments, such as those mentioned above, aren’t working well enough on their own. 

Do treatment options vary for different anger disorders?

Yes. According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), anger is not an official diagnosis. Because of this, no medication is FDA-approved to be used for anger specifically. 

So, when it comes to medications, it’s important to have a conversation with your healthcare provider to determine the cause of your anger and the best treatment option for you. 

In many cases, a medication may be prescribed to treat an underlying condition that could be causing anger or irritability, including: 

In other cases, depending on your situation, you may be told to use a medication off-label to treat your symptoms.

Antidepressants for anger

Some antidepressants can help treat anger, including selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly prescribed to treat conditions like depression and anxiety, but they’ve also been used to treat symptoms of anger or irritability. 

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SSRIs that have been shown to help with anger include citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), among others. Sertraline seems to have the most supporting data.

Other classes of antidepressants, like serotonin norepinephrine reuptake inhibitors (SNRIs), aren’t widely used for treating anger.

Anxiety medications for anger

In addition to antidepressants, some anxiety medications may also treat anger. 

Benzodiazepines are a group of anxiety medications that can treat anxiety and agitation in short-term situations. Sometimes, agitation may appear in the form of anger. Midazolam and lorazepam (Ativan) are fast-acting benzodiazepines that can be used for quick management of agitation, but they shouldn’t be taken long-term for this. 

Aside from SSRIs for anxiety, non-benzodiazepine anxiety medications don’t have as much supporting data for treating anger or agitation.

Antipsychotics for anger

Newer antipsychotics — also called atypical antipsychotics — may help with anger or agitation related to certain health conditions. Atypical antipsychotics are also sometimes used to treat agitation in older adults. 

We’ll go through a few examples here, but this isn’t an exhaustive list. 

Bipolar disorder

Antipsychotics or mood stabilizers are used to treat bipolar disorder, a condition where you have episodes of depression and mania. Many symptoms are possible during a manic episode, including anger or irritability. 

Manic episodes are usually treated with a mood stabilizer like lithium, plus an antipsychotic. Antipsychotics used to treat mania include olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). These medications are sometimes continued after the manic episode is over.

Disruptive mood dysregulation disorder

DMDD is a behavioral disorder in which children show signs of aggression or severe behavioral problems, lasting for at least a year. Atypical antipsychotics, like risperidone and aripiprazole, are sometimes used to treat DMDD, though these medications can have significant side effects. 

Keep in mind that other types of medications and treatments are usually used before trying antipsychotic medications.

Cannabis for anger

It’s not clear whether cannabis helps with anger. In one survey of adults with HIV, many people said they used cannabis to reduce anger. But there’s also evidence that cannabis can cause irritability and hostility in some people, especially in higher or stronger doses. 

Make sure to talk to a healthcare provider before potentially using cannabis or other THC-based products. Each of these products have risks, so your provider can explain the risks and benefits. And keep in mind: Cannabis is still illegal at the federal level, even though it’s allowed in some states.

Are there certain medications someone struggling with anger management should avoid?

While many medications may help with anger, some may make it worse. Make sure your healthcare provider has a full list of medications you take so they can see if any medications may be contributing to your symptoms. Here are some common examples:

In addition to medications, excessive alcohol intake can contribute to anger or violent outbursts. Mixing certain medications with alcohol can also make things worse. 

How much do anger medications cost?

The cost of anger medications varies. Fortunately, most of the medications discussed above are available as lower-cost generics. Prices vary by pharmacy and location, but this is what a 30-day supply of common medications tend to look like:

The bottom line

Certain life events can naturally cause anger, but it can also be a symptom of certain health conditions or other situations. It’s recommended to have a conversation with your healthcare provider if you have trouble managing your anger. Medications aren’t generally preferred for anger, but they can come in handy when other treatments haven’t worked. Common medication classes are antidepressants, anxiety medications, and antipsychotics. 

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Diagnosis

To determine a diagnosis of intermittent explosive disorder and eliminate other physical conditions or mental health disorders that may be causing your symptoms, your doctor will likely:

  • Do a physical exam. Your doctor will try to rule out physical problems or substance use that could be contributing to your symptoms. Your exam may include lab tests.
  • Do a psychological evaluation. Your doctor or mental health professional will talk to you about your symptoms, thoughts, feelings and behavior patterns.
  • Use the criteria in the DSM-5. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is often used by mental health professionals to diagnose mental conditions.

More Information

  • EEG (electroencephalogram)

Treatment

There’s no single treatment that’s best for everyone with intermittent explosive disorder. Treatment generally includes talk therapy (psychotherapy) and medication.

Psychotherapy

Individual or group therapy sessions that focus on building skills can be helpful. A commonly used type of therapy, cognitive behavioral therapy, helps people with intermittent explosive disorder:

  • Identify which situations or behaviors may trigger an aggressive response
  • Learn how to manage anger and control inappropriate responses using techniques such as relaxation training, thinking differently about situations (cognitive restructuring), and applying communication and problem-solving skills

Medication

Different types of medications may help in the treatment of intermittent explosive disorder. These may include certain antidepressants ― specifically selective serotonin reuptake inhibitors (SSRIs) ― anticonvulsant mood stabilizers or other drugs if needed.

More Information

  • Cognitive behavioral therapy

Coping and support

Controlling your anger

Part of your treatment may include:

  • Unlearning problem behavior. Coping well with anger is a learned behavior. Practice the techniques you learn in therapy to help you recognize what triggers your outbursts and how to respond in ways that work for you instead of against you.
  • Developing a plan. Work with your doctor or mental health professional to develop a plan of action for when you feel yourself getting angry. For example, if you think you might lose control, try to remove yourself from that situation. Go for a walk or call a trusted friend to try to calm down.
  • Improving self-care. Getting a good night’s sleep, exercising and practicing general stress management each day can help improve your frustration tolerance.
  • Avoiding alcohol or recreational or illegal drugs. These substances can increase aggressiveness and the risk of explosive outbursts.

If your loved one won’t get help

Unfortunately, many people with intermittent explosive disorder don’t seek treatment. If you’re involved in a relationship with someone who has intermittent explosive disorder, take steps to protect yourself and your children. The abuse isn’t your fault. No one deserves to be abused.

Create an escape plan to stay safe from domestic violence

If you see that a situation is getting worse, and suspect your loved one may be on the verge of an explosive episode, try to safely remove yourself and your children from the scene. However, leaving someone with an explosive temper can be dangerous.

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Consider taking these steps before an emergency arises:

  • Call a domestic violence hotline or a women’s shelter for advice, either when the abuser isn’t home or from a friend’s house.
  • Keep all firearms locked away or hidden. Don’t give the abuser the key or combination to the lock.
  • Pack an emergency bag that includes items you’ll need when you leave, such as extra clothes, keys, personal papers, medications and money. Hide it or leave the bag with a trusted friend or neighbor.
  • Tell a trusted neighbor or friend about the violence so that he or she can call for help if concerned.
  • Know where you’ll go and how you’ll get there if you feel threatened, even if it means you have to leave in the middle of the night. You may want to practice getting out of your home safely.
  • Come up with a code word or visual signal that means you need the police and share it with friends, family and your children.

Get help to protect yourself from domestic violence

These resources can help:

  • Police. In an emergency, call 911 or your local emergency number or your local law enforcement agency.
  • Your doctor or the emergency room. If you’re injured, doctors and nurses can treat and document your injuries and let you know what local resources can help keep you safe.
  • The National Domestic Violence Hotline: 1-800-799-SAFE (1-800-799-7233). This hotline is available for crisis intervention and referrals to resources, such as women’s shelters, counseling and support groups.
  • A local women’s shelter or crisis center. Shelters and crisis centers generally provide 24-hour emergency shelter, as well as advice on legal matters and advocacy and support services.
  • A counseling or mental health center. Many communities offer counseling and support groups for people in abusive relationships.
  • A local court. Your local court can help you get a restraining order that legally orders the abuser to stay away from you or face arrest. Local advocates may be available to help guide you through the process. You can also file assault or other charges when appropriate.

Preparing for your appointment

If you’re concerned because you’re having repeated emotional outbursts, talk with your doctor or make an appointment with a mental health professional who specializes in treating emotional disorders, such as a psychiatrist, psychologist or social worker. Here’s some information to help make the most of your appointment.

What you can do

Before your appointment, make a list of:

  • Symptoms you’re experiencing, including any that may seem unrelated to the reason for the appointment
  • Key personal information, including any major stresses, recent life changes and triggers for your outbursts
  • All medications, vitamins, herbs and other supplements that you’re taking, including the dosages
  • Questions to ask your doctor

Some basic questions to ask your doctor include:

  • Why am I having these angry outbursts?
  • Do I need any tests? Do these tests require any special preparation?
  • Is this condition temporary or long lasting?
  • What treatments are available, and which do you recommend?
  • Are there any side effects from treatment?
  • Are there any alternatives to the primary approach that you’re suggesting?
  • I have other health conditions. How can I best manage these conditions together?
  • Is there a generic alternative to the medicine you’re prescribing?
  • How long does therapy take to work?
  • Do you have any printed material I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • How often do you have explosive episodes?
  • What triggers your outbursts?
  • Have you injured or verbally abused others?
  • Have you damaged property when angry?
  • Have you ever tried to hurt yourself?
  • Have your outbursts negatively affected your family or work life?
  • Does anything seem to make these episodes occur more often or less often?
  • Is there anything that helps calm you down?
  • Has anyone else in your family ever been diagnosed with a mental illness?
  • Have you ever had a head injury?
  • Are you currently using alcohol, drugs or other substances?

Be ready to answer these questions so you can focus on points you want to spend more time on. Preparing and anticipating questions will help you make the most of your time with the doctor.

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