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Limited evidence that benzodiazepines are beneficial in the treatment of disturbed behaviour

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Question: Are benzodiazepines effective for the control of psychosis-induced aggression and disturbed behaviour, alone or when in combination with other antipsychotics?

Outcomes: Primary outcome: Global impression—no improvement in behaviour, mental state or symptoms. Secondary outcomes: experience of extrapyramidal symptoms. Given the acute nature of the indication, outcomes were assessed over the immediate term (0–15 min), short term (15 min–1 h) and medium term (1–48 h).


Design: Systematic review and meta-analysis.

Data sources: The Cochrane Schizophrenia Group's register, searched in January 2012. Reference lists of all included studies were hand searched for additional relevant trials and study authors were contacted to identify other sources of relevant information.

Study selection and analysis: Randomised controlled trials (RCTs) that included patients with psychosis-induced aggression or agitation and that compared benzodiazepine monotherapy with placebo or with antipsychotics; or that compared benzodiazepines in combination with antipsychotics with either drug as monotherapy or with antipsychotics in combination with antihistamines. Relative risks were calculated for dichotomous outcomes and assessed using a fixed effects model.

Main results

Twenty-one trials including 1968 participants were eligible. One very low-quality RCT (n=102) …

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  • Sources of funding None reported for the review; studies within the review received funding from variable sources.

  • Competing interests None.

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