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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.

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