Atypical Antipsychotics for Aggression

Clozapine and, to a lesser extent, olanzapine reduced aggression independent of their antipsychotic effects.

First-generation antipsychotic drugs (neuroleptics) can reduce aggression caused by hallucinations or delusions, but they lack primary antiaggressive effects. In a 12-week double-blind study, researchers compared the effects of haloperidol, olanzapine, and clozapine on aggressive behavior in 110 violent inpatients with chronic schizophrenia or schizoaffective disorder.

Patients who had engaged in a physical assault and in persistent physical or verbal aggression during their current hospitalization were randomized to receive gradually escalated doses of olanzapine (target dosage, 20 mg/day), clozapine (500 mg/day), or haloperidol (20 mg/day); these dosages were continued for 6 weeks. For the following 6 weeks, dosages were adjusted clinicall…

Reviewing Author

Steven Dubovsky, MD