Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-24T04:14:51.468Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of antipsychotic drugs against hostility in patients with schizophrenia in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study

Published online by Cambridge University Press:  28 November 2013

Jan Volavka ,
Pál Czobor ,
Leslie Citrome  and
Richard A. Van Dorn
Jan Volavka*
Affiliation:
Department of Psychiatry, New York University School of Medicine, New York, New York, USA
Pál Czobor
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
Leslie Citrome
Affiliation:
Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USA
Richard A. Van Dorn
Affiliation:
Research Triangle Institute International, Research Triangle Park, Durham, North Carolina, USA
*
*Address for correspondence: Jan Volavka, P.O. Box 160663, Big Sky, MT 59716, USA. (Email janvolavka@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Aggressive behavior can be a dangerous complication of schizophrenia. Hostility is related to aggression. This study aimed to compare the effects of olanzapine, perphenazine, risperidone, quetiapine, and ziprasidone on hostility in schizophrenia.

Methods

We used the data that were acquired in the 18-month Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. We analyzed the scores of the Positive and Negative Syndrome Scale (PANSS) hostility item in a subset of 614 patients who showed at least minimal hostility (a score ≥ 2) at baseline.

Results

The primary analysis of hostility indicated an effect of difference between treatments (F4,1487 = 7.78, P < 0.0001). Olanzapine was significantly superior to perphenazine and quetiapine at months 1, 3, 6, and 9. It was also significantly superior to ziprasidone at months 1, 3, and 6, and to risperidone at months 3 and 6.

Discussion

Our results are consistent with those of a similar post-hoc analysis of hostility in first-episode subjects with schizophrenia enrolled in the European First-Episode Schizophrenia Trial (EUFEST) trial, where olanzapine demonstrated advantages compared with haloperidol, quetiapine, and amisulpride.

Conclusion

Olanzapine demonstrated advantages in terms of a specific antihostility effect over the other antipsychotics tested in Phase 1 of the CATIE trial.

Keywords

schizophreniahostilityaggressionantipsychotics
Type
Original Research
Information
CNS Spectrums , Volume 19 , Issue 5 , October 2014 , pp. 374 - 381
Copyright
Copyright © Cambridge University Press 2013 

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

1. Volavka, J. Neurobiology of Violence, 2nd ed. Washington, DC: American Psychiatric Publishing, Inc.; 2002.Google Scholar
2. Stroup, TS, McEvoy, JP, Swartz, MS, etal. The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project: schizophrenia trial design and protocol development. Schizophr Bull. 2003; 29(1): 15–31.CrossRefGoogle ScholarPubMed
3. Lieberman, JA, Stroup, TS, McEvoy, JP, etal. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005; 353(12): 1209–1223.CrossRefGoogle ScholarPubMed
4. Swanson, JW, Swartz, MS, Van Dorn, RA, etal. A national study of violent behavior in persons with schizophrenia. Arch Gen Psychiatry. 2006; 63(5): 490–499.CrossRefGoogle ScholarPubMed
5. Fazel, S, Langstrom, N, Hjern, A, Grann, M, Lichtenstein, P. Schizophrenia, substance abuse, and violent crime. JAMA. 2009; 301(19): 2016–2023.CrossRefGoogle ScholarPubMed
6. Kay, SR, Opler, LA, Lindenmayer, JP. The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. Br J Psychiatry. 1989; 155(Suppl 7): 59–65.CrossRefGoogle Scholar
7. Witt, K, van Dorn, R, Fazel, S. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PLoS One. 2013; 8(2): e55942.CrossRefGoogle ScholarPubMed
8. Volavka, J, Czobor, P, Derks, EM, etal. Efficacy of antipsychotic drugs against hostility in the European First-Episode Schizophrenia Trial (EUFEST). J Clin Psychiatry. 2011; 72(7): 955–961.CrossRefGoogle ScholarPubMed
9. Kay SR, Opler LA, Fiszbein A. Positive and Negative Syndrome Scale (PANSS) rating manual. 1986. Unpublished work.CrossRefGoogle Scholar
10. Little, RC, Milliken, GA, Stroup, WW, Wolfinger, RD, Schabenberger, O. SAS for Mixed Models, 2nd ed. Cary, NC: SAS Press; 2006.Google Scholar
11. Swanson, JW, Swartz, MS, Van Dorn, RA, etal. Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia. Br J Psychiatry. 2008; 193(1): 37–43.CrossRefGoogle ScholarPubMed
12. Krakowski, MI, Czobor, P, Citrome, L, Bark, N, Cooper, TB. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2006; 63(6): 622–629.CrossRefGoogle ScholarPubMed
13. Citrome, L, Volavka, J, Czobor, P, etal. Effects of clozapine, olanzapine, risperidone, and haloperidol on hostility in treatment-resistant patients with schizophrenia and schizoaffective disorder. Psychiatr Serv. 2001; 52(11): 1510–1514.CrossRefGoogle Scholar
14. Czobor, P, Volavka, J, Meibach, RC. Effect of risperidone on hostility in schizophrenia. J Clin Psychopharmacol. 1995; 15(4): 243–249.CrossRefGoogle ScholarPubMed
15. Volavka, J, Czobor, P, Citrome, L, etal. Efficacy of aripiprazole against hostility in schizophrenia and schizoaffective disorder: data from 5 double-blind studies. J Clin Psychiatry. 2005; 66(11): 1362–1366.CrossRefGoogle ScholarPubMed
16. Citrome, L, Volavka, J, Czobor, P, etal. Efficacy of ziprasidone against hostility in schizophrenia: post hoc analysis of randomized, open-label study data. J Clin Psychiatry. 2006; 67(4): 638–642.CrossRefGoogle ScholarPubMed
17. Kinon, BJ, Roychowdhury, SM, Milton, DR, Hill, AL. Effective resolution with olanzapine of acute presentation of behavioral agitation and positive psychotic symptoms in schizophrenia. J Clin Psychiatry. 2001; 62(Suppl 2): 17–21.Google ScholarPubMed
18. Arango, C, Bernardo, M. The effect of quetiapine on aggression and hostility in patients with schizophrenia. Hum Psychopharmacol. 2005; 20(4): 237–241.CrossRefGoogle ScholarPubMed
19. Chengappa, KN, Goldstein, JM, 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(2): 530–541.CrossRefGoogle ScholarPubMed
20. Volavka, J, Swanson, JW, Citrome, LL. Understanding and managing violence in schizophrenia. In: Lieberman JA, Murray RM, eds. Comprehensive Care of Schizophrenia: A Textbook of Clinical Management, 2nd ed. New York: Oxford University Press; 2012: 262–290.Google Scholar
21. Geddes, J, Freemantle, N, Harrison, P, Bebbington, P. Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. BMJ. 2000; 321(7273): 1371–1376.CrossRefGoogle ScholarPubMed
22. Moller, HJ. Do effectiveness (“real world”) studies on antipsychotics tell us the real truth? Eur Arch Psychiatry Clin Neurosci. 2008; 258(5): 257–270.CrossRefGoogle ScholarPubMed
23. Kinon, BJ, Volavka, J, Stauffer, V, etal. Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder: a randomized, double-blind, fixed-dose study. J Clin Psychopharmacol. 2008; 28(4): 392–400.CrossRefGoogle ScholarPubMed
24. Citrome, L, Holt, RI, Walker, DJ, Hoffmann, VP. Weight gain and changes in metabolic variables following olanzapine treatment in schizophrenia and bipolar disorder. Clin Drug Investig. 2011; 31(7): 455–482.CrossRefGoogle ScholarPubMed
25. Volavka, J, Citrome, L. Heterogeneity of violence in schizophrenia and implications for long-term treatment. Int J Clin Pract. 2008; 62(8): 1237–1245.CrossRefGoogle ScholarPubMed
26. Swanson, JW, Van Dorn, RA, Swartz, MS, etal. Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems. Law Hum Behav. 2008; 32(3): 228–240.CrossRefGoogle ScholarPubMed
27. Laajasalo, T, Salenius, S, Lindberg, N, Repo-Tiihonen, E, Hakkanen-Nyholm, H. Psychopathic traits in Finnish homicide offenders with schizophrenia. Int J Law Psychiatry. 2011; 34(3–4): 324–330.CrossRefGoogle ScholarPubMed
28. Abushua'leh, K, bu-Akel, A. Association of psychopathic traits and symptomatology with violence in patients with schizophrenia. Psychiatry Res. 2006; 143(2–3): 205–211.CrossRefGoogle ScholarPubMed