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 .
Atypical Antipsychotics, Neurocognitive Deficits, and Aggression in Schizophrenic Patients
The purpose of this study was to compare the effects of olanzapine , clozapine , and haloperidol on neurocognitive function in schizophrenic patients who present with documented episodes of physical aggression and to determine whether change in cognitive function is related to aggression . One hundred physically aggressive schizophrenic in patients were assigned to a r and omized , double-blind , parallel-group , 12-week treatment , and received cognitive evaluations at baseline . There were 33 , 34 , and 33 subjects in the clozapine , olanzapine , and haloperidol groups , respectively . They were administered a battery of tests assessing psychomotor function , general executive function , visual and verbal memory , and visuospatial ability . A general cognitive index was derived from the above battery . The overall score on the Modified Overt Aggression Scale was used to measure the number and severity of the aggressive events . Psychiatric symptoms and side effects were also assessed . The improvement in the general cognitive index differed significantly among the 3 treatment groups , with olanzapine being superior to both haloperidol and clozapine . Further analyses revealed significantly greater improvement with olanzapine in several cognitive domains . Furthermore , improvement in the general cognitive index was significantly associated with a decrease in aggression in the olanzapine group but not in the other 2 medication groups . In violent schizophrenic patients , olanzapine treatment is associated with better cognitive functioning relative to haloperidol and clozapine . This improvement in neurocognitive function is associated with a decrease in aggressive behavior . As clozapine markedly reduced aggression , there may be different pathways for the antiaggressive effect of olanzapine and that of clozapine
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 .