Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-27T17:53:31.911Z Has data issue: false hasContentIssue false

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*
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:[email protected] (I. Bitter).
Get access

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.

Type
Original article
Copyright
Copyright ©Elsevier SAS 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bitter, I., Basson, B.R., Dossenbach, M.R.Antipsychotic treatment and sexual functioning in first-time neuroleptic-treated schizophrenic patients. Int. Clin. Psychopharmacol., 2005; 20: 11921CrossRefGoogle ScholarPubMed
Buckley, P., Bartell, J., Donenwirth, K., Lee, S., Torigoe, F., Schulz, S.C.Violence and schizophrenia: clozapine as a specific antiaggressive agent. Bull. Am. Acad. Psychiatry Law 1995; 23: 607611Google ScholarPubMed
Chengappa, K.N., Goldstein, J.M., Greenwood, M., John, V., Levine, J.A post hoc analysis of the impact on hostility and agitation of quetiapine and haloperidol among patients with schizophrenia. Clin. Ther., 2003; 25: 2530541CrossRefGoogle ScholarPubMed
Chiles, J.A., Davidson, P., McBride, D.Effects of clozapine on use of seclusion and restraint at a state hospital. Hosp. Community Psychiatry 1994; 45: 269271Google Scholar
Citrome, L., Volavka, J., Czobor, P., Sheitman, B., Lindenmayer, J.-P., McEvoy, J., et al.Effects of clozapine, olanzapine, risperidone, and haloperidol on hostility in treatment-resistant patients with schizophrenia and schizoaffective disorder. Psychiatr. Serv. 2001; 52: 15101514CrossRefGoogle Scholar
Czobor, P., Volavka, J., Meibach, R.C.Effect of risperidone on hostility in schizophrenia. J. Clin. Psychopharmacol. 1995; 15: 243249CrossRefGoogle Scholar
Dossenbach, M., Erol, A., el Mahfoud, K.M., Shaheen, M.O., Sunbol, M.M., Boland, J., et al.Effectiveness of antipsychotic treatments for schizophrenia: interim 6-month analysis from a prospective observational study (IC-SOHO) comparing olanzapine, quetiapine, risperidone, and haloperidol. J. Clin. Psychiatry, 2004; 65: 3312321CrossRefGoogle ScholarPubMed
Ebrahim, G.M., Gibler, B., Gacono, C.B., Hayes, G.Patient response to clozapine in a forensic psychiatric hospital. Hosp. Community Psychiatry 1994; 45: 271273Google Scholar
Guy, W.ECDEU Assessment Manual for Psychopharmacology Rockville: National Institute of Mental Health; 1976Google Scholar
Haro, J.M., Kamath, S.A., Ochoa, S., Novick, D., Rele, K., Fargas, A., et al.The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta. Psychiatr. Scand. 416Suppl2003 1623CrossRefGoogle Scholar
Kinon, B.J., Roychowdhury, S.M., Milton, D.R., Hill, A.L.Effective resolution with olanzapine of acute presentation of behavioral agitation and positive psychotic symptoms in schizophrenia. J. Clin. Psychiatry 62Suppl 22001 1721Google Scholar
Korb, F.A., Trzebiatowska, I., Janikova, E., Winkler-Skaza, V., Ilies, D., Peciukaitiene, D., et al.The Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study: Baseline clinical and functional characteristics and antipsychotic use of patterns in the Central and Eastern Europe (CEE) region. Psychiatria Danubina 2003; 15: 163174Google ScholarPubMed
Korb, F.A., Yenilmez, C., Belaid, A., Ghazi, M., Omar, A.-E., Bitter, I.The intercontinental schizophrenia outpatient health outcomes (ic-soho) study: baseline clinical and functional characteristics and antipsychotic use patterns in the North Africa and Middle Eastern (amea) region. South African Psychiatry Review 2004; 7: 2734Google Scholar
Maier, G.J.The impact of clozapine on 25 forensic patients. Bull. Am. Acad. Psychiatry Law 1992; 20: 297307Google ScholarPubMed
Mallya, A.R., Roos, P.D., Roebuck-Colgan, K.Restraint, seclusion, and clozapine. J. Clin. Psychiatry 1992; 53: 395397Google ScholarPubMed
Ratey, J.J., Leveroni, C., Kilmer, D., Gutheil, C., Swartz, B.The effects of clozapine on severely aggressive psychiatric inpatients in a state hospital. J. Clin. Psychiatry 1993; 54: 219223Google Scholar
Spivak, B., Roitman, S., Vered, Y., Mester, R., Graff, E., Talmon, Y., et al.Diminished suicidal and aggressive behavior, high plasma norepinephrine levels, and serum triglyceride levels in chronic neuroleptic-resistant schizophrenic patients maintained on clozapine. Clin. Neuropharmacol., 1998; 21: 4245250Google ScholarPubMed
Swanson, J.W., Swartz, M.S., Elbogen, E.B., Van Dorn, R.A.Reducing violence risk in persons with schizophrenia: olanzapine versus risperidone. J. Clin. Psychiatry, 2004; 65: 1216661673CrossRefGoogle ScholarPubMed
Treuer, T., Dossenbach, M., Meder, J., Herman, E., Pecenak, J., Tavar, R., et al.Observational study of schizophrenia outpatients in Central and Eastern Europe: 3- and 6-month efficacy and safety results. Socialna Psihijatria 2004; 32: 4957Google Scholar
Volavka, J.Neurobiology of Violence. 2 edWashington, DC: American Psychiatric Publishing, Inc.; 2002Google Scholar
Volavka, J., Laska, E., Baker, S., Meisner, M., Czobor, P., Krivelevich, I.History of violent behaviour and schizophrenia in different cultures. Analyses based on the WHO study on determinants of outcome of severe mental disorders. Br. J. Psychiatry 1997; 171: 914CrossRefGoogle Scholar
Volavka, J., Zito, J.M., Vitrai, J., Czobor, P.Clozapine effects on hostility and aggression in schizophrenia. J. Clin. Psychopharmacol. 1993; 13: 287289CrossRefGoogle Scholar
Wilson, W.H., Claussen, A.M.18-month outcome of clozapine treatment for 100 patients in a state psychiatric hospital. Psychiatr. Serv. 1995; 46: 386389Google Scholar
Submit a response

Comments

No Comments have been published for this article.