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 .
Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol.
BACKGROUND Prolactin levels are elevated to varying degrees by antipsychotics . Prolactin elevations may result in sexual and other adverse effects , and they may be related to antipsychotic effects . We used the data collected in a trial of antipsychotics to study the differential effect of these drugs on prolactin level , to explore the relation between clinical effects and prolactin level , and to determine the relationship between plasma levels of antipsychotics and prolactin level . METHOD Treatment-resistant patients ( 133 men , 24 women ) diagnosed with DSM-IV schizophrenia or schizoaffective disorder participated in a double-blind , r and omized , 14-week trial comparing clozapine ( N = 40 ) , olanzapine ( N = 39 ) , risperidone ( N = 41 ) , and haloperidol ( N = 37 ) . Plasma levels of prolactin and antipsychotics were determined at baseline and at weeks 5 , 8 , 10 , 12 , and 14 during the trial . Clinical effects were measured with the Positive and Negative Syndrome Scale and the Extrapyramidal Symptom Rating Scale . Statistical analyses were limited to the 75 men for whom repeated prolactin levels were available . Data were gathered from June 1996 to December 1999 . RESULTS Risperidone caused significant elevation of prolactin levels ( p < .05 ) that appeared to be dose-dependent . Clozapine and olanzapine were associated with decreases of prolactin , whereas haloperidol led to a minor , nonsignificant increase . Plasma olanzapine and prolactin levels were correlated . Prolactin levels were not related to clinical improvement or extrapyramidal side effects . CONCLUSION Antipsychotics show major differences in their effects on prolactin , and risperidone has clearly the most robust effect
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 .