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Antipsychotic medications do not differ substantially in ability to reduce violent behaviour in people with schizophrenia

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QUESTION

Question:

Do antipsychotic medications differ in the ability to reduce violent behaviour in people with schizophrenia?

Patients:

1493 adults with schizophrenia (DSM-IV), aged 18–65 years. Detailed inclusion and exclusion criteria are not reported in this article.

Setting:

The NIMH Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project; 57 US sites (academic and community); January 2001–December 2004.

Intervention:

Olanzapine (7.5 mg capsule), quetiapine (200 mg capsule), risperidone (1.5 mg), perphenazine (8 mg capsule) or ziprasidone (40 mg capsule). Doses were altered according to clinical judgement, with up to 4 capsules given daily.

Outcomes:

Primary outcome: change in violent behaviour from baseline to 6 months (MacArthur Community Violence Interview—a combined measure of minor (eg, assault without injury) and serious (eg, assault with a weapon) violent behaviours). Information was collected from both the participant and family members.

Patient follow-up:

45% of participants completed 6 months of treatment and were included in the retained sample; 97% were included in the intention to treat (ITT) sample (48 participants were excluded …

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