Pindolol augmentation in aggressive schizophrenic patients: a double-blindcrossover randomized study

Treatment of aggression in schizophrenic patients is a major challenge. We sought to examine the efficacy of augmentation of antipsychotic treatment w ith pindolol in the amelioration of aggression. Thirty male inpatients meet ing DSM-IV criteria for schizophrenia, aged 20-65 years involved in four or more aggressive incidents in the two previous months, were enrolled in a d ouble-blind crossover study. Aggression was evaluated per incident,,vith th e Overt Aggression Scale (OAS). Positive and Negative Syndrome Scale (PANSS ) was administered at baseline, crossover and at endpoint. Patients receive d either pindolol or placebo augmentation 5 mg x three times a day until cr ossover, then switched. No significant differences were found in the PANSS scores between the placebo and pindolol treatments. OAS scores were signifi cantly reduced for number of aggressive incidents towards objects and other persons during pindolol treatment (0.59 versus 1.46, F = 6.09, P < 0.02; 1 .96 versus 3.23, F = 4.17, P < 0.05, respectively). Similar results were ob tained for severity of incidents (0.89 versus 3.58, F = 19.42, P < 0.0001; 2.89 versus 6.85, F = 10.11, P < 0.004, respectively). Pindolol, with its d ual beta and 5-HT1A blocking effect ameliorated both number and severity of aggressive acts. Influence on severity may be associated with a 5-HT1A ant agonistic effect. (C) 2001 Lippincott Williams & Wilkins.