THE EFFECTS OF CLOZAPINE ON SEVERELY AGGRESSIVE PSYCHIATRIC-INPATIENTS IN A STATE-HOSPITAL

Background: After noting a dramatic reduction in aggression and agitat ion in five psychotic inpatients residing on a specialized unit for th e severely aggressive, the authors conducted a retrospective chart rev iew to assess the possible role of clozapine treatment in this change. Method. The authors culled 12 months of nursing data, including progr ess notes, orders for seclusion, and mechanical and chemical restraint , to tabulate the frequency of aggression before and after the initiat ion of clozapine treatment, and looked at ratings on the Brief Psychia tric Rating Scale and periodic review reports to assess overall clinic al change. Results: The results of the review indicate that although p sychotic symptoms were not greatly affected by the drug, the overall f requency of assaults, self-abuse, and the use of seclusion, mechanical restraint, and chemical restraint was reduced in the subjects. Conclu sion: The authors conclude that because the reduction of aggression an d agitation coincided with clozapine treatment, it is likely that cloz apine was responsible for the change. The authors propose possible rea sons for this effect and suggest that controlled studies are needed to substantiate these preliminary results.