title: Effects of quetiapine and olanzapine in patients with psychosis and violent behavior: a pilot randomized, open-label, comparative study.
abstract: OBJECTIVE
  Patients suffering from psychosis are more likely than the general population to commit aggressive acts, but the therapeutics of aggressive behavior are still a matter of debate.
  
  
  METHODS
  This pilot randomized, open-label study compared the efficacy of quetiapine versus olanzapine in reducing impulsive and aggressive behaviors (primary endpoints) and psychotic symptoms (secondary endpoints) from baseline to days 1, 7, 14, 28, 42, 56, and 70, in 15 violent schizophrenic patients hospitalized in a maximum-security psychiatric hospital.
  
  
  RESULTS
  Quetiapine (525±45 mg) and olanzapine (18.5±4.8 mg) were both efficacious in reducing Impulsivity Rating Scale from baseline to day 70. In addition, both treatments reduced the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression Scale scores at day 70 compared to baseline, and no differences were observed between treatments. Moreover, quetiapine, but not olanzapine, yielded an improvement of depressive symptoms in the items "depression" in Brief Psychiatric Rating Scale and "blunted affect" in Positive and Negative Syndrome Scale. Modified Overt Aggression Scale scores were also decreased from baseline to the endpoint, but due to the limited number of patients, it was not possible to detect a significant difference.
  
  
  CONCLUSIONS
  In this pilot study, quetiapine and olanzapine equally decreased impulsive and psychotic symptoms after 8 weeks of treatment. Double-blind, large studies are needed to confirm the validity of these two treatments in highly aggressive and violent schizophrenic patients.
authors.affiliation: Neurobiological Psychiatric Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montréal, QC, Canada ; Institut Philippe Pinel, Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Gobbi
authors.affiliation: Neurobiological Psychiatric Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montréal, QC, Canada.
authors.forename: Stefano
authors.initials: S
authors.lastname: Comai
authors.affiliation: Neurobiological Psychiatric Unit, Department of Psychiatry, McGill University and McGill University Health Center, Montréal, QC, Canada ; Institut Philippe Pinel, Department of Psychiatry, Université de Montréal, Montréal, QC, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Debonnel
keywords: aggression; atypical antipsychotics; depressive symptoms; impulsivity; schizophrenia; violence