I dont have a complete prescipitating and predisposing factor for the ex husband to make a good root cause analysis for him. I only know of sasuke's. But, the ex husband and sasuke both have something in common, which were important at that moment : intent to harm and kill. Human instinct when a person wants to kill you, you wont tolerate the harm.
You can maybe understand that an abused person would not be able to see himself or herself as a victim of abuse, but two or three times, if that happens to someone, dont you think there's something wrong with not only one person's sanity but also of the other's sense of self-respect? IT Takes two to be in an abusive relationship, and this one (Sasusaku) is abusive and toxic. Sakura is not being a martyr for tolerating it, and Sasuke, as youve said yourself, is insane.
If he was bwing insane and emotionally unavailable to reciprocate at that time, why would you want your favorite female character to be harmed? This is he guy who got trained by orochimaru and you think, you aeriously think, you can easily poison him, in close range too?