Micronutrient Therapy for Violent and Aggressive Male Youth- an Open Label Pilot trial

Background: Pharmacotherapy for aggressive and violent behavior disorders in male children and adolescents is associated with significant adverse events. Treatments with more acceptable risk–benefit ratios are critically needed.Micronutrient intervention will be investigated as an alternative in the management of these behaviors. Methods: Males aged 4–14 who displayed ongoing violent and aggressive behaviors received micronutrient intervention containing alpha-tocopherol, ascorbic acid, biotin, chromium, pyridoxal-5-phosphate (P5P), pyridoxine, selenium, and zinc, in a 16-week open-label trial. Plasma zinc, plasma copper, copper/zinc ratio, and urinary pyrrole (HPL) tests were conducted at baseline and endpoint. Participants were examined for changes in aggressive and violent behaviors measured using the Children’s Aggression Scale and the Modified Overt Aggression Scale, improvements in family functioning measured using the Family Functioning Style Scale, improvements in health-related quality of life at baseline, 8 weeks, endpoint. Results: Thirty-two male children met inclusion criteria. Thirtyone completed the study. Micronutrient therapy significantly improved parent reported aggressive and violent behaviors measured using the CAS (p < 0.001 to p = 0.02) with medium to large effect size (Cohen’s d = 0.72–1.43) and the MOAS (p < 0.001) with large effect size (Cohen’s d = 1.26). Parent-reported HRQoL (p < 0.001; Cohen’s d = −1.69) and family functioning (p = 0.03; Cohen’s d = −0.41) also significantly improved. Conclusion: Micronutrient therapy appeared well tolerated, with a favorable side effect profile. It appeared effective in the reduction of parent-reported aggressive and violent behaviors, and showed improvement in family functioning and HRQoL in male youth after 16 weeks.