Pharmacopsychiatry 2010; 43(6): 205-209
DOI: 10.1055/s-0030-1254091

© Georg Thieme Verlag KG Stuttgart · New York

Trials Assessing Parmacotherapeutic Management of Aggression in Psychiatric Patients: Comparability with Clinical Practice

L. E. Goedhard1 , 2 , J. J. Stolker2 , 3 , H. L. I. Nijman1 , 4 , T. C. G. Egberts2 , 5 , E. R. Heerdink1 , 2 , 5
  • 1Altrecht Institute for Mental Health Care, Den Dolder, The Netherlands
  • 2Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht, The Netherlands
  • 3Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
  • 4Academic Center of Social Sciences, Radboud University Nijmegen, The Netherlands
  • 5Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands
Further Information

Publication History

received 05.07.2009 revised 05.01.2010

accepted 08.03.2010

Publication Date:
29 June 2010 (online)


Introduction: In a previous review of randomized controlled trials (RCTs) on the pharmacotherapeutic management of aggression, it was shown that there is only weak evidence of effectiveness. In the present study we aim to determine comparability of patients included in these RCTs and patients of psychiatric long-stay wards.

Methods: Exclusion criteria that were used in at least 20% of the RCTs were applied to a sample of aggressive inpatients from clinical practice, in order to find what proportion of these patients would be eligible to participate in the reviewed, high quality RCTs.

Results: Only 30% of aggressive psychiatric patients as seen in clinical practice would be eligible to participate in a typical randomized controlled trial based on the most frequently applied exclusion criteria.

Discussion: The low comparability of patients included in RCTs with those seen in clinical practice may decrease the generalizability of the findings form RCTs to clinical practice.



E. R. Heerdink

Utrecht University

Faculty of Science

Utrecht Institute for

Pharmaceutical Sciences

Division of Pharmacoepidemiology & Pharmacotherapy

PO Box 80 082

3508 TB Utrecht

The Netherlands

Phone: +31-3025 37 324

Fax: +31-3025 39 166