A groundbreaking medical trial has revealed that a common antidepressant can significantly reduce rates of domestic violence reoffending, offering a potential new tool in tackling what has been declared a national crisis in many countries, including the UK.
A New Pharmacological Approach to Prevention
Conducted by researchers from the University of New South Wales and the University of Newcastle, the world-first study tested whether sertraline – a widely prescribed selective serotonin reuptake inhibitor (SSRI) – could curb violent tendencies. The trial focused on 630 impulsive men with histories of aggression, recruited between 2013 and 2021 primarily through community corrections offices and courts in New South Wales.
In this double-blind study, neither the participants nor the researchers knew who was receiving sertraline or a placebo. While the results for general violence were inconclusive, the data on domestic violence reoffending showed a clear and significant impact.
Striking Reductions in Reoffending Rates
The trial found that men who took sertraline were less likely to reoffend in a domestic violence context. At the 12-month mark, offending stood at 19.1% in the sertraline group, compared to 24.8% for those on the placebo. This positive trend continued, with rates of 28.2% versus 35.7% respectively at the 24-month point.
Perhaps the most compelling finding was that sertraline reduced the rate of repeated domestic violence offending by 44% compared to the placebo. For participants who adhered more consistently to their medication regimen, the reduction in reoffending reached 30% at 24 months.
How Medication and Support Work Together
Sertraline works by enhancing serotonin function in the brain, which is crucial for regulating impulses and emotional responses. For highly impulsive men, this directly targets a key driver of reactive violence in intimate relationships. An initial four-week phase saw notable improvements: a 55% reduction in depression, 44% in psychological distress, 35% in anger, 25% in irritability, and 20% in impulsivity.
However, the researchers emphasise that medication alone was not enough. The study evolved to include a comprehensive support model, combining pharmacotherapy with trauma-informed counselling, 24-hour crisis support, and help navigating services. This was vital for engagement, particularly as many participants faced complex issues like homelessness, substance use, and untreated mental health disorders.
One participant described the change, stating he was able to walk away from a potential road rage confrontation, crediting the medication for giving him control. The benefits extended to partners, with 96% reporting maintained or increased safety, 85% observing positive behavioural changes, and 77% noting improved personal wellbeing.
Implications for Policy and Practice
The research, led by Professor Tony Butler and his team, suggests this combined approach is not only effective but also cost-effective. The annual cost was approximately A$7,000 per participant, starkly lower than the A$150,000 for incarceration. The model's operation through a university, independent of government systems, helped build trust with men who had negative prior experiences with institutions.
This evidence-based intervention provides a new perspective on prevention, focusing on addressing the psychological and social drivers of domestic violence in perpetrators. The researchers stress it does not diminish the need for victim support or the importance of tackling structural issues like gender inequality, but offers a proven method to reduce harm now.
As domestic violence remains a critical issue globally, including in the UK, this trial highlights a promising, scalable addition to the prevention ecosystem that could be implemented to protect families and save lives.
