Abstract: Objective To investigate the effectiveness and adverse reactions of magnesium valproate in combination with risperidone or quetiapine in the treatment of aggressive behavior in schizophrenic patients. Methods A total of 64 schizophrenic patients with aggressive behavior who were admitted to Chongqing Mental Health Center from March 2018 to June 2019 were selected. According to the random number table method, they were divided into two groups. In the observation group, 32 patients were treated with magnesium valproate and risperidone. The control group was treated with magnesium valproate in combination with risperidone. The Positive and Negative Syndrome Scale (PANSS) was used to assess the psychiatric symptoms of 64 patients. Patients' aggressive behavior was assessed by the Modified Overt Aggression Scale (MOAS). The adverse reactions in 64 patients were recorded using the Treatment Emergent Symptom Scale (TESS). Results The adverse reactions were mild in the patients of both groups, with clinical symptoms of dizziness, and akathisia, etc. There were no significant differences in electrocardiogram and other indicators. The overall adverse reaction in the control group was not significantly different from that in the observation group (P>0.05). The observation group showed remarkably improved PANSS scores and the MOAS scores, compared with the control group (P<0.05). There was no significant difference in the total effective rate of psychiatric symptoms between the two groups (P>0.05). Conclusions The combined use of magnesium valproate and risperidone or quetiapine, can enhance therapeutic effectiveness, improve patient's mental state, and relieve aggressive behavior. It is beneficial to eliminate potential risks, with high safety and without adverse reactions, which is worthy of clinical application.