The Effects of Molindone as a Concomitant Medication on Aggressive BehaviorAuthor(s): J.P. Lindenmayer, Frances Alcantara , Anzalee Khan, Michael Ciranni
Background: After noting a significant reduction in aggression and agitation in treatment-refractory patients with molindone augmentation in severely aggressive inpatients, the authors conducted a retrospective medical records review to assess the possible anti-aggressive role of molindone treatment in a larger cohort of treatment-refractory inpatients. Method: Twenty-four weeks of data from thirty inpatients who were consecutively augmented with molindone, including progress notes, orders for seclusion, chemical restraint, and scores on the Agitation-Calmness Evaluation Scale (ACES) were systematically collected. The number of seclusions, number of as-needed medications (PRNs) and ACES scores were used to tabulate the frequency of aggression and agitation episodes during the 8-week period before, 8 weeks after, and 9 through16 weeks after the initiation of molindone augmentation treatment. Results: Over the observation period of twenty-four weeks, the number of episodes of PRN medication administration for agitation and aggression significantly decreased during molindone treatment, the degree of agitation significantly improved, and there was a nonsignificant trend effect of reduction of the number of seclusion episodes. The mean dose of molindone used was 186 mg. Conclusions: These data suggest a role for molindone augmentation in the treatment of persistently aggressive patients with severe treatment-refractory psychosis. The authors propose possible reasons for this effect and suggest that controlled studies are needed to substantiate these preliminary results.