2005 issue 3

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Volume 14, issue 3

Review article

Second - generation antipsychotic medications in the treatment of aggression

LESZEK BIDZAN1
1. Kliniki Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego Akademii Medycznej w Gdańsku
Postępy Psychiatrii i Neurologii 2005; 14 (3): 195-221
Keywords: second-generation antipsychotic, aggression

Abstract

Objective. This article reviews the application of second-generation antipsychotic medications in the treatment of aggression and agitation in the course of schizophrenia, mental retardation and senile dementia.

Review. Many medications have been used in the treatment of aggressive disorders and agitation but it is very difficult to appraise their efficacy and safety, mainly because of the paucity of randomised, placebo-controlled studies. Other serious methodological limitations include: lack of unified inclusion criteria, heterogeneous methods of appraisal of therapeutic efficacy, inadequate sample selection due to vaguely-defined concepts of aggression and agitation, and inadequate control groups. Clinical outcomes largely depend on the medical condition in which aggressive states are involved. Agitation has traditionally been treated with neuroleptics and second-generation neuroleptics have been applied more and more frequently in recent years.

Conclusion. Research to date suggests that clozapine is the most effective treatmentfor aggressive behaviour of all second-generation neuroleptic medications.

Address for correspondence:
Prof. Leszek Bidzan, Klinika Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego Akademii Medycznej, ul. Srebrniki 1, 80-282 Gdańsk, tel./fax: (58) 3446085, e-mail: kpsych@amg.gda.pl