Impulsive Aggressive Behavior in Medicine / Internal Medicine — 28yo Man | Psychiatry | SMLE Q#1216

SMLE Question #1216

Medicine / Internal Medicine Psychiatry
Last updated: February 2026
A 28-year-old man is brought to the emergency department by police after repeatedly starting fights at a bar. Friends report years of aggressive outbursts and poor impulse control over minor disagreements. He denies hallucinations and denies substance use today. Neurologic examination is normal. Dysregulation of which neurotransmitter system is most directly associated with impulsive aggressive behavior?

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