Prof Ted Dinan says treatment with the Prozac family of drugs holds out promise for some who have anger management problems - but only, he says, when other methods have failed.
"There is no magic bullet for this condition," he said. "I only see drugs therapy as a real last resort when psychological interventions have failed."
Psychotherapy, one of the so-called "talking cures", remains the treatment of choice in many cases of excessive anger and most cases are referred to a psychologist or a counsellor by GPs or psychiatrists.
Psychotherapist Ray O'Sulllivan takes anger management cases referred by other health professionals. He starts by taking a look at the patient's family experiences and background. "Sometimes in looking at that you can see sites for the source of some of the anger. I would then look at processing it for the client and helping them to deal with it. Unresolved issues from the past can affect the issues of today."
Not all his patients display John McEnroe-type symptoms.
"The ones we all hear about are the violent eruptives but some people show anger by withdrawing from relationships. We try and free up the roadblocks and help them to move forward."
Therapists have a repertoire of techniques, or interventions as they call them.
"One thing is to look at behaviour. We ask the patient to visualise their anger like a scale. If a situation in work puts you at seven on a scale of 10 where you are ready to boil, we would say try to imagine it if the pointer were, say, at five. We explore what goes on before they do explode, and try to identify the triggers and come up with ways of dealing with them in the future.
"We explore with the patient ways of removing themselves from the situation through things like meditation, listening to music or simply going for a walk. Talking about anger as a problem and assessing it is an intervention in itself because therapy is often the very first time clients have addressed the issue."
There is no set scale of charges for psychotherapy although the €65 an hour O'Sullivan charges is typical.
There are few anger management specialists in Ireland, unlike the US, where it is a psychotherapy discipline in itself but most well-trained psychotherapists here include it in their range of counselling services. A typical course of treatment would extend to eight or 10 sessions at fortnightly or monthly intervals and O'Sullivan says it can take up to three sessions before a good working relationship is developed with the client.
Although it is freely available on the UK National Health Service, O'Sullivan says anger management counselling is not available as a free service for Irish public patients or medical card holders unless the condition is a symptom of a wider psychiatric problem.
However, some therapists may offer a sliding scale based on income and hospitals occasionally offer reduced fee treatments to less well-off patients as training projects for therapists.
The Irish Council for Psychotherapy (01-2722111, E-mail: info@icpty.ie Website: http://www.icpty.ie maintains a list of recognised psychotherapists.