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   Child Adolesc Psychopharmacol. 2017 May 8. doi: 10.1089/cap.2016.0199. [Epub   
   ahead of print]   
      
   Micronutrient Therapy for Violent and Aggressive Male Youth: An Open-Label   
   Trial.   
      
   Hambly JL1, Francis K2, Khan S1,3, Gibbons KS3, Walsh WJ4, Lambert B5, Testa   
   C6, Haywood A1,3.   
   Author information   
   1   
   1 School of Pharmacy, Menzies Health Institute Queensland, Griffith University   
   , Southport, Australia .   
   2   
   2 Happiness in Health , West Burleigh, Queensland, Australia .   
   3   
   3 Mater Research Institute-The University of Queensland , Brisbane,   
   Queensland, Australia .   
   4   
   4 Walsh Research Institute , Naperville, Illinois.   
   5   
   5 Applied Analytical Laboratories , Meadowbrook, Queensland, Australia .   
   6   
   6 Chris Testa's Tugun Compounding Pharmacy , Tugun, Queensland, Australia .   
   Abstract   
   OBJECTIVES:   
   Pharmacotherapy for problematic 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 to bridge the therapeutic   
   gap in the management of these behaviors.   
   METHODS:   
   Males aged 4-14 who displayed ongoing violent and aggressive behaviors   
   received micronutrient intervention containing alpha-tocopherol (vitamin E),   
   ascorbic acid (vitamin C), biotin, chromium, pyridoxal-5-phosphate (P5P),   
   pyridoxine (vitamins B6),    
   selenium, and zinc, in a 16-week open-label trial. Plasma zinc, plasma copper,   
   copper/zinc ratio, and urinary hydroxyhemopyrroline-2-one (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 (CAS) and the   
   Modified Overt Aggression Scale (MOAS), improvements in family functioning   
   measured using the Family Functioning Style Scale, improvements in   
   health-related quality of life (HRQoL)    
   measured using the Pediatric Quality of Life Inventory (PedsQL) at baseline, 8   
   weeks, endpoint, and at 4-6-month follow-up.   
   RESULTS:   
   Thirty-two male children and adolescents met inclusion criteria. Thirty-one   
   (mean 8.35 ± standard deviation 2.93 years) completed the study, with one   
   participant lost to follow-up. Micronutrient therapy significantly improved   
   parent-reported    
   aggressive and violent behaviors measured using the CAS for all domains except   
   the use of weapons (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. Further research in the form of a double-blinded, randomized controlled   
   trial is required to verify these initial positive observations.   
   KEYWORDS:   
   aggression; children; males; micronutrients; violence   
   PMID: 28481642 DOI: 10.1089/cap.2016.0199   
      
   https://www.ncbi.nlm.nih.gov/pubmed/28481642   
      
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