ADJUNCTIVE NADOLOL IN THE TREATMENT OF ACUTELY AGGRESSIVE SCHIZOPHRENIC-PATIENTS

Background: This study assessed the safety and efficacy of nadolol 120 mg/day compared with placebo, when administered adjunctively to neuro leptic in a group of acutely aggressive schizophrenic patients. Method : Thirty-four male patients enrolled in this double-blind, placebo-con trolled trial. The subjects were evaluated with the Brief Psychiatric Rating Scale (BPRS) and the Simpson-Angus Neurologic Rating Scale for extrapyramidal effects. The total BPRS score as well as three factors, thought disturbance, hostility, and activation, was analyzed. Results : Compared with those who received placebo, the patients taking nadolo l showed significant improvement on total BPRS score, particularly on the thought disturbance and activation factors, after the first treatm ent week (p = .05). By the end of the second treatment week, the patie nts taking placebo also began to show improvement, and the group diffe rences were no longer significant. The patients treated with nadolol s howed significantly more improvement on Simpson-Angus scores than thos e who received placebo (p = .03). However, there was no significant co rrelation between BPRS and Simpson-Angus changes. In the madolol group , patients with and without akathisia showed no significant difference in their BPRS scores. Conclusion: These findings suggest that adjunct ive nadolol may be useful in the treatment of acutely aggressive schiz ophrenic patients by inducing a more rapid and consistent decrease of overall psychiatric symptoms and by reducing the extrapyramidal effect s. Our results raise the possibiliity that the mechanism of action of nadolol on psychiatric symptoms in schizophrenic patients may be diffe rent from the mechanism of improvement of neuroleptic-induced extrapyr amidal symptoms and akathisia. Nadolol may be a helpful adjunctive tre atment for schizophrenic patients in general and not just for those wi th a high hostility level.