Two Cases of Perospirone-Induced Mania in Schizophrenia

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Sir: Agitation, aggression, and hostility are frequent manifestations of psychiatric illnesses, with symptoms ranging from mild irritability to marked physical violence. "The Expert Consensus Guidelines: Treatment of Schizophrenia"¹ recommends valproate as a first-line adjunctive therapy for hostility/aggression, indicating that there is a subgroup of schizophrenia patients whose hostility and aggression persist despite adequate antipsychotic therapy. Research suggests that valproate demonstrates efficacy in the treatment of agitation and impulsive aggression in psychiatric patients.^2,3 The current study was designed to evaluate the efficacy of adjunctive valproate in schizophrenia outpatients who exhibit persistent hostility despite prolonged olanzapine therapy.