The Effects of Clozapine Versus Haloperidol on Measures of Impulsive Aggression and Suicidality in Chronic Schizophrenia Patients: An Open, Nonrandomized, 6-Month Study
J Clin Psychiatry 2003;64:755-760
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The risk of suicide for
schizophrenia patients is 20 to 50 times higher than that for the
general population. Long-term treatment with clozapine, an
atypical antipsychotic, has been shown to reduce the rate of
suicide by 80% to 85%. The goal of the present study was to
examine whether clozapine's effect on the reduction of suicidal
behavior in chronic schizophrenic patients could be due to a
reduction in impulsive-aggressive behavior.
Method: 44 patients with chronic DSM-IV
schizophrenia were treated with clozapine or haloperidol
decanoate in an open prospective 6-month trial. Changes in
measures of suicidality, impulsiveness, aggression, depressed
mood, and positive and negative symptoms were assessed at
baseline and at 6 months.
Results: The clozapine-treated group (N =
18) had a significantly greater reduction on all outcome measures
compared with the haloperidol decanoate-treated group (N = 26).
Only in the clozapine-treated group did the reduction in measures
of suicidality correlate significantly with a reduction in
impulsiveness and aggression. The reductions in suicidality and
impulsive aggression were not significantly correlated with
reductions in depressed mood or positive and negative symptom
scores in either group.
Conclusion: These data suggest that the
reduction in suicidality following long-term clozapine treatment
may be related to a reduction in impulsiveness and aggression.