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

Caspi, N.a; Modai, I.a,b; Barak, P.aa; Waisbourd, A.a; Zbarsky, H.a; Hirschmann, S.a; Ritsner, M.a,b

International Clinical Psychopharmacology: March 2001 - Volume 16 - Issue 2 - p 111-115
Research Papers

Treatment of aggression in schizophrenic patients is a major challenge. We sought to examine the efficacy of augmentation of antipsychotic treatment with pindolol in the amelioration of aggression. Thirty male inpatients meeting 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 double-blind crossover study. Aggression was evaluated per incident, with the Overt Aggression Scale (OAS). Positive and Negative Syndrome Scale (PANSS) was administered at baseline, crossover and at endpoint. Patients received either pindolol or placebo augmentation 5 mg × three times a day until crossover, then switched. No significant differences were found in the PANSS scores between the placebo and pindolol treatments. OAS scores were significantly 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 obtained 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 dual β and 5-HT1A blocking effect ameliorated both number and severity of aggressive acts. Influence on severity may be associated with a 5-HT1A antagonistic effect.

aSha'ar Menashe Mental Health Center and Institute of Psychiatric Studies and bBruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel

Correspondence to Ilan Modai, Sha'ar Menashe Mental Health Center, Mobile Post Hefer 38814, Israel; Tel: +972 6 6379287; fax: +972 6 6278880; e-mail:

Received: 15 February 2000; accepted 6 July 2000

© 2001 Lippincott Williams & Wilkins, Inc.