Effect of clozapine on physical and verbal aggression

Jonathan Rabinowitz, Moshe Avnon, Victor Rosenberg

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Objective: The hypothesis that clozapine reduces serious physically and verbally aggressive behavior of persons with schizophrenia whose symptoms did not respond to typical neuroleptic treatment was tested. Method: Incident reports of aggression and restraint of 75 such inpatients were reviewed for 3 months before clozapine treatment and for 6 months of clozapine treatment. BPRS scores were also examined. Twenty-eight patients with no incidents were removed from study. Results: There were significantly fewer incidents of physical aggression per month per patient on clozapine than before clozapine (mean ± S.D. = 0.13 ± 0.25 vs. 0.54 ± 0.93; t = 3.4, df = 46, p < 0.002) and a similar decline in verbal aggression (0.21 ± 0.31 vs. 0.73 ± 0.83; t = 4.3, df = 46, p < 0.000). On clozapine, 49% (n = 23) of patients had fewer incidents of physical aggression, 36% (n = 17) showed no change and 15% (n = 7) showed more. Seventy percent (n = 33) of patients had fewer incidents of verbal aggression, 4% (n = 2) showed no change and 25% (n = 12) had more. During the 3 months before clozapine, 14 patients (30%) were restrained a total of 40 times. During the first 6 months of clozapine treatment, three patients (6%) were restrained a total of six times. There were significant decreases in BPRS hostility, positive, negative and psychosis scores. Conclusion: Clozapine appears to reduce serious aggression among some patients.

Original languageEnglish
Pages (from-to)249-255
Number of pages7
JournalSchizophrenia Research
Issue number3
StatePublished - 15 Dec 1996


  • aggression
  • clozapine
  • neuroleptic non-response
  • schizophrenia


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