MAIN RESULTS We have no good- quality evidence of the absolute effectiveness of haloperidol for people with long-term aggression .
When haloperidol was compared with olanzapine or clozapine , skewed data ( n=83 ) at high risk of bias suggested some advantage in terms of scale scores of unclear clinical meaning for olanzapine/clozapine for ' total aggression ' .
Although there were some data for the outcomes listed above , there were no data on most of the binary outcomes and none on service outcomes ( use of hospital/police ) , satisfaction with treatment , acceptance of treatment , quality of life or economics .
BACKGROUND Psychotic disorders can lead some people to become agitated .
Characterised by restlessness , excitability and irritability , this can result in verbal and physically aggressive behaviour - and both can be prolonged .
Aggression within the psychiatric setting imposes a significant challenge to clinicians and risk to service users ; it is a frequent cause for admission to inpatient facilities .
If people continue to be aggressive it can lengthen hospitalisation .
Haloperidol is used to treat people with long-term aggression .
OBJECTIVES To examine whether haloperidol alone , administered orally , intramuscularly or intravenously , is an effective treatment for long-term/persistent aggression in psychosis .
Effects of atypical antipsychotics on the syndromal profile in treatment-resistant schizophrenia.
BACKGROUND There has been considerable support for the observation that atypical antipsychotics have a broader range of therapeutic effects than traditional antipsychotics . We are exploring whether this exp and ed clinical efficacy can also be seen in patients with treatment-resistant schizophrenia . METHOD The subjects were 157 treatment-resistant in patients diagnosed with DSM-IV schizophrenia or schizoaffective disorder . They were r and omly assigned to treatment with clozapine , olanzapine , risperidone , or haloperidol in a 14-week double-blind trial and rated with a st and ard measure of clinical antipsychotic efficacy ( Positive and Negative Syndrome Scale [ PANSS ] ) . Factor analysis at baseline and endpoint together with changes in 5 PANSS-derived factors were examined . Data were gathered from June 1996 to December 1999 . RESULTS The underlying PANSS factor structure , as indicated by the factor loadings , was essentially identical at baseline and endpoint . At baseline , the excitement factor was followed by the positive , negative , cognitive , and depression/anxiety factors , explaining 49.4 % of the total variance . At endpoint , the positive factor was followed by the negative , excitement , cognitive , and depression/anxiety factors , explaining 55.5 % of the total variance . The endpoint data indicated statistically significant ( p < .05 ) improvements over time on the positive factor for all 3 atypicals , but not for haloperidol . The negative factor showed significant improvement for clozapine and olanzapine , with significant worsening for haloperidol . Clozapine , olanzapine , and risperidone were superior to haloperidol on the negative factor , while clozapine was also superior to risperidone . The cognitive factor showed significant improvement for all atypicals , as did the depression/anxiety factor . Only clozapine showed improvement on the excitement factor and was superior to both haloperidol and risperidone . CONCLUSIONS Treatment with atypical antipsychotics did not substantially change the underlying PANSS 5-factor structure . However , antipsychotic treatment with all 3 atypical medications was associated with significant improvements on 3 of 5 syndromal domains ( positive , cognitive , and depression/anxiety ) of schizophrenia . Clozapine and olanzapine also showed improvement on the negative factor . Only clozapine was associated with improvement on the excitement domain . This finding confirms that atypicals are associated with improvement of an exp and ed spectrum of symptoms in treatment-resistant patients
MAIN RESULTS We have no good- quality evidence of the absolute effectiveness of haloperidol for people with long-term aggression .
When haloperidol was compared with olanzapine or clozapine , skewed data ( n=83 ) at high risk of bias suggested some advantage in terms of scale scores of unclear clinical meaning for olanzapine/clozapine for ' total aggression ' .
Although there were some data for the outcomes listed above , there were no data on most of the binary outcomes and none on service outcomes ( use of hospital/police ) , satisfaction with treatment , acceptance of treatment , quality of life or economics .
BACKGROUND Psychotic disorders can lead some people to become agitated .
Characterised by restlessness , excitability and irritability , this can result in verbal and physically aggressive behaviour - and both can be prolonged .
Aggression within the psychiatric setting imposes a significant challenge to clinicians and risk to service users ; it is a frequent cause for admission to inpatient facilities .
If people continue to be aggressive it can lengthen hospitalisation .
Haloperidol is used to treat people with long-term aggression .
OBJECTIVES To examine whether haloperidol alone , administered orally , intramuscularly or intravenously , is an effective treatment for long-term/persistent aggression in psychosis .