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Effectiveness of clozapine, olanzapine, quetiapine, risperidone, and haloperidol monotherapy in reducing hostile and aggressive behavior in outpatients treated for schizophrenia: a prospective naturalistic study (IC-SOHO)

Published online by Cambridge University Press:  16 April 2020

Istvan Bitter ,
Pal Czobor ,
Martin Dossenbach  and
Jan Volavka
Istvan Bitter*
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa u. 6, 1083Budapest, Hungary
Pal Czobor
Affiliation:
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA New York University, New York, NY, USA DOV Pharmaceutical, Inc., Hackensack, NJ, USA
Martin Dossenbach
Affiliation:
Eli Lilly Ges.m.b.H., Vienna, Austria
Jan Volavka
Affiliation:
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA New York University, New York, NY, USA
*
*Corresponding author. Tel./fax: +36 1 303 6244. E-mail address:bitter@psych.sote.hu (I. Bitter).
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Abstract

Objective

Antipsychotic medications may reduce hostile and aggressive behavior in schizophrenia. This study compared the effectiveness of antipsychotics in the treatment of aggression.

Method

The Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study compares the effectiveness of antipsychotic treatments in practice setting. Schizophrenia outpatients who initiated or changed to a new antipsychotic are followed in this non-interventional, prospective observational study for up to 3 years, with 6-months data now available on the entire cohort (N = 7655). The presence or absence of verbal or physical hostility/aggression was assessed retrospectively for the period of 6 months before enrollment, and prospectively in the period of 6 months after enrollment (the study treatment period). At baseline, patients in five monotherapy treatment groups (combined N = 3135) were prescribed one of the treatments: clozapine, olanzapine, quetiapine, risperidone, or haloperidol, and had complete data.

Results

Hostile/aggressive behavior was reduced during the treatment period. Olanzapine and risperidone were significantly superior to haloperidol and to clozapine in this respect. These results remained essentially unchanged when adjusting for baseline imbalances in age, gender, age of onset, and substance abuse.

Conclusions

As monotherapy, both olanzapine and risperidone were superior to haloperidol and clozapine in reducing aggression. The relative lack of effectiveness of clozapine may be specific to this study population.

Keywords

SchizophreniaAggressionAntipsychotics
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 5-6 , August 2005 , pp. 403 - 408
Copyright
Copyright ©Elsevier SAS 2005

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