Overt Aggression and Psychotic Symptoms in Patients with Schizophrenia Treated with Clozapine, Olanzapine, Risperidone, or Haloperidol

Jan Volavka, P. Czobor, Karen Nolan, Brian Sheitman, Jean Pierre Lindenmayer, Leslie Citrome, Joseph P. McEvoy, Thomas B. Cooper, Jeffrey A. Lieberman

Research output: Article

138 Citations (Scopus)

Abstract

The subjects were 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder. They were randomly assigned to treatment with clozapine, olanzapine, risperidone, or haloperidol in a 14-week, double-blind trial. Incidents of overt aggression were recorded and their severity was scored. The Positive and Negative Syndrome Scale was administered. Atypical antipsychotics showed an overall superiority over haloperidol, particularly after the first 24 days of the study when the dose escalation of clozapine was completed. Once an adequate therapeutic dose of clozapine was reached, it was superior to haloperidol in reducing the number and severity of aggressive incidents. Patients exhibiting persistent aggressive behavior showed less improvement of psychotic symptoms than the other patients. There was an interaction between aggressiveness, medication type, and antipsychotic response: risperidone and olanzapine showed better antipsychotic efficacy in patients exhibiting less aggressive behavior; the opposite was true for clozapine. Clozapine appears to have superior antiaggresive effects in treatment-resistant patients; this superiority develops after the patient has been exposed to an adequate dose regimen.

Original languageEnglish
Pages (from-to)225-228
Number of pages4
JournalJournal of Clinical Psychopharmacology
Volume24
Issue number2
DOIs
Publication statusPublished - ápr. 2004

Fingerprint

olanzapine
Risperidone
Clozapine
Haloperidol
Aggression
Schizophrenia
Antipsychotic Agents
Therapeutics
Psychotic Disorders
Inpatients

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Overt Aggression and Psychotic Symptoms in Patients with Schizophrenia Treated with Clozapine, Olanzapine, Risperidone, or Haloperidol. / Volavka, Jan; Czobor, P.; Nolan, Karen; Sheitman, Brian; Lindenmayer, Jean Pierre; Citrome, Leslie; McEvoy, Joseph P.; Cooper, Thomas B.; Lieberman, Jeffrey A.

In: Journal of Clinical Psychopharmacology, Vol. 24, No. 2, 04.2004, p. 225-228.

Research output: Article

Volavka, Jan ; Czobor, P. ; Nolan, Karen ; Sheitman, Brian ; Lindenmayer, Jean Pierre ; Citrome, Leslie ; McEvoy, Joseph P. ; Cooper, Thomas B. ; Lieberman, Jeffrey A. / Overt Aggression and Psychotic Symptoms in Patients with Schizophrenia Treated with Clozapine, Olanzapine, Risperidone, or Haloperidol. In: Journal of Clinical Psychopharmacology. 2004 ; Vol. 24, No. 2. pp. 225-228.
@article{86056b7a7f9047aba0d9a4d152f01b5d,
title = "Overt Aggression and Psychotic Symptoms in Patients with Schizophrenia Treated with Clozapine, Olanzapine, Risperidone, or Haloperidol",
abstract = "The subjects were 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder. They were randomly assigned to treatment with clozapine, olanzapine, risperidone, or haloperidol in a 14-week, double-blind trial. Incidents of overt aggression were recorded and their severity was scored. The Positive and Negative Syndrome Scale was administered. Atypical antipsychotics showed an overall superiority over haloperidol, particularly after the first 24 days of the study when the dose escalation of clozapine was completed. Once an adequate therapeutic dose of clozapine was reached, it was superior to haloperidol in reducing the number and severity of aggressive incidents. Patients exhibiting persistent aggressive behavior showed less improvement of psychotic symptoms than the other patients. There was an interaction between aggressiveness, medication type, and antipsychotic response: risperidone and olanzapine showed better antipsychotic efficacy in patients exhibiting less aggressive behavior; the opposite was true for clozapine. Clozapine appears to have superior antiaggresive effects in treatment-resistant patients; this superiority develops after the patient has been exposed to an adequate dose regimen.",
author = "Jan Volavka and P. Czobor and Karen Nolan and Brian Sheitman and Lindenmayer, {Jean Pierre} and Leslie Citrome and McEvoy, {Joseph P.} and Cooper, {Thomas B.} and Lieberman, {Jeffrey A.}",
year = "2004",
month = "4",
doi = "10.1097/01.jcp.0000117424.05703.29",
language = "English",
volume = "24",
pages = "225--228",
journal = "Journal of Clinical Psychopharmacology",
issn = "0271-0749",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Overt Aggression and Psychotic Symptoms in Patients with Schizophrenia Treated with Clozapine, Olanzapine, Risperidone, or Haloperidol

AU - Volavka, Jan

AU - Czobor, P.

AU - Nolan, Karen

AU - Sheitman, Brian

AU - Lindenmayer, Jean Pierre

AU - Citrome, Leslie

AU - McEvoy, Joseph P.

AU - Cooper, Thomas B.

AU - Lieberman, Jeffrey A.

PY - 2004/4

Y1 - 2004/4

N2 - The subjects were 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder. They were randomly assigned to treatment with clozapine, olanzapine, risperidone, or haloperidol in a 14-week, double-blind trial. Incidents of overt aggression were recorded and their severity was scored. The Positive and Negative Syndrome Scale was administered. Atypical antipsychotics showed an overall superiority over haloperidol, particularly after the first 24 days of the study when the dose escalation of clozapine was completed. Once an adequate therapeutic dose of clozapine was reached, it was superior to haloperidol in reducing the number and severity of aggressive incidents. Patients exhibiting persistent aggressive behavior showed less improvement of psychotic symptoms than the other patients. There was an interaction between aggressiveness, medication type, and antipsychotic response: risperidone and olanzapine showed better antipsychotic efficacy in patients exhibiting less aggressive behavior; the opposite was true for clozapine. Clozapine appears to have superior antiaggresive effects in treatment-resistant patients; this superiority develops after the patient has been exposed to an adequate dose regimen.

AB - The subjects were 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder. They were randomly assigned to treatment with clozapine, olanzapine, risperidone, or haloperidol in a 14-week, double-blind trial. Incidents of overt aggression were recorded and their severity was scored. The Positive and Negative Syndrome Scale was administered. Atypical antipsychotics showed an overall superiority over haloperidol, particularly after the first 24 days of the study when the dose escalation of clozapine was completed. Once an adequate therapeutic dose of clozapine was reached, it was superior to haloperidol in reducing the number and severity of aggressive incidents. Patients exhibiting persistent aggressive behavior showed less improvement of psychotic symptoms than the other patients. There was an interaction between aggressiveness, medication type, and antipsychotic response: risperidone and olanzapine showed better antipsychotic efficacy in patients exhibiting less aggressive behavior; the opposite was true for clozapine. Clozapine appears to have superior antiaggresive effects in treatment-resistant patients; this superiority develops after the patient has been exposed to an adequate dose regimen.

UR - http://www.scopus.com/inward/record.url?scp=1642274542&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1642274542&partnerID=8YFLogxK

U2 - 10.1097/01.jcp.0000117424.05703.29

DO - 10.1097/01.jcp.0000117424.05703.29

M3 - Article

C2 - 15206671

AN - SCOPUS:1642274542

VL - 24

SP - 225

EP - 228

JO - Journal of Clinical Psychopharmacology

JF - Journal of Clinical Psychopharmacology

SN - 0271-0749

IS - 2

ER -